Colon & Rectal Disease Center, Inc.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

COLON & RECTAL DISEASE CENTER, INC.

Practice address

10496 Montgomery Rd
Suite 204
Cincinnati, OH 45242-5220

Phone

(513) 793-9835

Fax

(513) 793-9837

NPI assigned

Jul 23, 2007

Organization subpart

No

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

Authorized official

Name

Mahendra Matta, MDNPI 1518936814

Title

Owner

Phone

(513) 793-9835

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15932/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mahendra K Matta, MD

  • Surgery Physician
  • Cincinnati, OH
  • NPI 1518936814
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1447450804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10496 MONTGOMERY RD",
            "address_2": "SUITE 204",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452425220",
            "telephone_number": "513-793-9835",
            "fax_number": "513-793-9837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10496 MONTGOMERY RD",
            "address_2": "SUITE 204",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452425220",
            "telephone_number": "513-793-9835",
            "fax_number": "513-793-9837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLON & RECTAL DISEASE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "MATTA",
        "authorized_official_first_name": "MAHENDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-793-9835",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abraham Collum
• Pamela Jane Colman, M.D.
• Olivia A Coloian
• George Colombel, M.D.
• Greta Colombo, LPC
• Brianna Nicole Colon
• Johanna Colon
• Nicole Colosimo, RD, LD
• Lisa Marie Colquitt, LPN
• Tawnee Colson

• Colon & Rectal Surgery Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Colon & Rectal Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.