Katherine Lynn Mattern, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9106262 Issued in FL

Practice address

650 S Courtenay Pkwy
Suite 200
Merritt Island, FL 32952-4977

Phone

(321) 394-2660

Fax

(321) 394-2669

NPI assigned

Aug 1, 2007

Last updated

Apr 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katherine.mattern.1@8042.direct.athenahealth.com
• Direct secure messaging: kmattern71622@epicdirect.hf.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Privia Medical Group Florida, LLC

  • General Practice Physician
  • Indialantic, FL
  • NPI 1700649043
  Medicare reassignment Care Compare group
• Jeffrey T Obrien MD Inc

  dba The Orthopedic Center

  • Durable Medical Equipment & Medical Supplies
  • Merritt Island, FL
  • NPI 1619146321
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cape Canaveral Hospital, Inc.

  • General Acute Care Hospital
  • Cocoa Beach, FL
  • NPI 1184691610
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1417148743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 S COURTENAY PKWY",
            "address_2": "SUITE 200",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524977",
            "telephone_number": "321-394-2660",
            "fax_number": "321-394-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S COURTENAY PKWY",
            "address_2": "SUITE 200",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524977",
            "telephone_number": "321-394-2660",
            "fax_number": "321-394-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTERN",
        "first_name": "KATHERINE",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9772073",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "202014",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL  MEDICARE",
            "identifier": "NS448",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sophia Marvel
• Emma Mason-Young
• Jennifer Massa
• Jane C Mast, P.A.-C
• Susan Louise Matschner
• Robert Andrew Matthews, DMD
• Vanessa Matthews
• Lisa Mazzatto
• Kristin McAleenan, M.S. CCC-SLP
• Jessica McAllister, RBT

• Physician Assistant in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.