Individual provider Active NPI

Irati Rodriguez Matesanz, RN, MSN, FNP-BC

  • Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1528766433
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN302167 Issued in GA
Practice address
600 Celebrate Life Pkwy
Newnan, GA 30265-8001
Phone
(400) 600-7000
NPI assigned
Feb 20, 2023
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN302167 GA Primary
Registered Nurse 163W00000X RN302167 GA

Addresses

Primary practice location

600 Celebrate Life Pkwy
Newnan, GA 30265-8001

Mailing address

247 Prescott CT
Newnan, GA 30265-6021
Phone (678) 416-8177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20230912003319 GA Practitioner - Nurse Practitioner 2062876840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City of Hope Medical Group of Georgia LLCGroup PAC ID 4880841212, 137 clinicians

Practice addresses (Care Compare)

600 Celebrate Life Pkwy
Newnan, GA 30265-8001
Phone (770) 400-6080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.74 of 100Reported as group
Quality
63.81
Promoting interoperability
100
Improvement activities
40
Cost
57.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Group of Georgia LLC CurrentSince Aug 14, 2023 Accepting new patients

Locations

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

62742 Collections Ctr Dr
Chicago, IL 60693

Interoperability endpoints

  • Direct secure messaging: irodriguezmatesanz144821@cityofhope.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1528766433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 PRESCOTT CT",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302656021",
            "telephone_number": "678-416-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CELEBRATE LIFE PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658001",
            "telephone_number": "400-600-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ MATESANZ",
        "first_name": "IRATI",
        "credential": "RN, MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN302167",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN302167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.