Individual provider Active NPI

James M Mattucci Jr., MD

  • Orthopaedic Surgery Physician
  • Kingston, PA
National Provider Identifier
1528070778
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD067772L Issued in PA
Practice address
390 Pierce St
Kingston, PA 18704-5532
Phone
(570) 288-3535
Fax
(570) 288-0804
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD067772L PA Primary

Addresses

Primary practice location

390 Pierce St
Kingston, PA 18704-5532

Mailing address

390 Pierce St
Kingston, PA 18704-5532
Phone (570) 288-3535

Other identifiers 2

IdentifierTypeStateIssuer
1444722OtherPABS
0018537730002MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address james.mattucci.1@21771.direct.athenahealth.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120201000570 PA Practitioner - Orthopedic Surgery 7113184243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Temple University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Physician Network LLCGroup PAC ID 2668696592, 63 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1000 Meade St
Dunmore, PA 18512-3195

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

390 Pierce St
Kingston, PA 18704-5532
Phone (570) 408-0410

4 E Main St
Nanticoke, PA 18634-1602
Phone (570) 735-7474

575 N River St
Wilkes Barre, PA 18702-2634
Phone (570) 552-8938

6011 Sr
Suite 6
Tunkhannock, PA 18657-7753
Phone (570) 836-7600

Hospital & facility affiliations

  • Commonwealth Home Health & Hospice of Wilkes-Barre Home health agency, Forty Fort, PA, CCN 397021
  • Accentcare Health of Pennsylvania Home health agency, Bristol, PA, CCN 397472
  • Associated Family Home Care, Inc. Home health agency, Kingston, PA, CCN 397502
  • Traditional Home Health Care Home health agency, Dunmore, PA, CCN 397774
  • Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137
  • Regional Hospital of Scranton Hospital, Scranton, PA, CCN 390237
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001
  • John Heinz Institute of Rehabilitation Medicine Inpatient rehabilitation facility, Wilkes Barre Townshi, PA, CCN 393036

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement13
Knee replacement21
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD067772LPAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Physician Network LLC CurrentSince Apr 1, 2019 Accepting new patients

Locations

1000 Meade St
Ste 106
Dunmore, PA 18512
Phone (570) 207-0171

390 Pierce St
Kingston, PA 18704
Phone (570) 288-3535

4 E Main St
Nanticoke, PA 18634
Phone (570) 258-3939

6011 Sr 6
Tunkhannock, PA 18657
Phone (570) 836-7600

Interoperability endpoints

  • Direct secure messaging: james.mattucci.1@21771.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1528070778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 PIERCE ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045532",
            "telephone_number": "570-288-3535",
            "fax_number": "570-288-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 PIERCE ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045532",
            "telephone_number": "570-288-3535",
            "fax_number": "570-288-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTUCCI",
        "first_name": "JAMES",
        "middle_name": "M",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD067772L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "1444722",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018537730002",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.mattucci.1@21771.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "390 Pierce St",
            "city": "Kingston",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187045532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.