Individual provider Active NPI

Mattison McCray Pearlman, PA-C

  • Physician Assistant
  • Long Beach, CA
National Provider Identifier
1508377847
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60501 Issued in CA
Practice address
320 Pine Ave Ste 1030
Long Beach, CA 90802-2366
Phone
(310) 360-7200
NPI assigned
Oct 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6829 AZ
Physician Assistant 363A00000X PA60501 CA Primary

Addresses

Primary practice location

320 Pine Ave Ste 1030
Long Beach, CA 90802-2366

Mailing address

2502 W Calle Morado
Tucson, AZ 85745-2523
Phone (602) 469-0781

Other practice location 1

3250 W Lower Buckeye Rd
Phoenix, AZ 85009-6729
Phone (602) 876-7114

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Techcare Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20221003002219 CA Practitioner - Physician Assistant 2769868405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thomas Health Services IncGroup PAC ID 1355748021, 32 clinicians

Practice addresses (Care Compare)

320 Pine Ave
Suite 1030
Long Beach, CA 90802-2366
Phone (310) 360-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
60501CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
6829AZMDPhysician Assistant
PA60501CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stephens Medical Corporation CurrentSince Aug 18, 2024 Accepting new patients

Locations

320 Pine Ave
Ste 1030
Long Beach, CA 90802
Phone (310) 360-7200

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": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1508377847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 W CALLE MORADO",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452523",
            "telephone_number": "602-469-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 PINE AVE STE 1030",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908022366",
            "telephone_number": "310-360-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3250 W Lower Buckeye Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850096729",
            "country_code": "US",
            "telephone_number": "602-876-7114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARLMAN",
        "first_name": "MATTISON",
        "middle_name": "MCCRAY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6829",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Techcare",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3250 W Lower Buckeye Rd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850096729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.