Individual provider Active NPI

Brenda Mattson, PT BOCO

  • Orthotist
  • Falmouth, ME
National Provider Identifier
1417967415
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OrthotistTaxonomy code 222Z00000X
License
C15212 Issued in MD
Practice address
170 US Route One
Suite 180
Falmouth, ME 04105
Phone
(207) 781-5369
Fax
(207) 781-5862
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X C15212 MD Primary
Physical Therapist 225100000X PT0512 ME

Addresses

Primary practice location

170 US Route One
Suite 180
Falmouth, ME 04105

Mailing address

19 Phillips Road
Falmouth, ME 04105
Phone (207) 781-5369

Other identifiers 6

IdentifierTypeStateIssuer
M23095OtherCIGNA
2434074OtherAETNA DME
M230950OtherCIGNA DME
1042321OtherAETNA
018251OtherANTHEM BCBS
37938OtherHARVARD PILGRIM

Other names 1

  • Brenda Mattson Harfield Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C15212MDMDOrthotist
PT0512MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Physical Therapy Connection Orthotist Past Accepting new patients
Foundations Pediatrics, PLLC Orthotist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1417967415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 PHILLIPS ROAD",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "04105",
            "telephone_number": "207-781-5369",
            "fax_number": "207-781-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 US ROUTE ONE",
            "address_2": "SUITE 180",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "04105",
            "telephone_number": "207-781-5369",
            "fax_number": "207-781-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "BRENDA",
        "name_prefix": "Ms.",
        "credential": "PT BOCO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "MD",
            "license": "C15212",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT0512",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "M23095",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA DME",
            "identifier": "2434074",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA DME",
            "identifier": "M230950",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1042321",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "018251",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "37938",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "HARFIELD",
            "middle_name": "MATTSON",
            "credential": "PT BOCO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Falmouth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.