William Joseph Mattiace, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD044878L Issued in PA

Practice address

1205 River Ave
1St Floor
Williamsport, PA 17701-3724

Phone

(570) 323-5991

Fax

(570) 323-6578

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Family Practice Center, PC

  • Physical Therapist
  • Middleburg, PA
  • NPI 1154376937

  Family Medicine

  Medicare reassignment NPD
• Family Practice Center, PC

  • Clinical Medical Laboratory
  • Selinsgrove, PA
  • NPI 1033322466
  NPD
• Susquehanna Physician Services

  • Pulmonary Disease Physician
  • Williamsport, PA
  • NPI 1083677868
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1518906262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 RIVER AVE",
            "address_2": "1ST FLOOR",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013724",
            "telephone_number": "570-323-5991",
            "fax_number": "570-323-6578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIACE",
        "first_name": "WILLIAM",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD044878L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012801050003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Lynne Mathers
• Scott Andrew Mathias, PSY.D.
• Jacquelyn Matthews, CRNA
• Morgan Matthews
• Rosanne Mattiace
• Maxim Healthcare Services Inc
• Maxim Healthcare Services, Inc.
• Laura Nicole Maxwell-Rankin, CRNP
• Jennifer Janet May, PA-C
• Myriah May

• Family Medicine Physician in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.