Individual provider Active NPI

Stephen A Mattera, DC

  • Chiropractor
  • Wayne, NJ
National Provider Identifier
1548357957
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00296800 Issued in NJ
Practice address
1817 Hamburg Tpke
Wayne, NJ 07470-6217
Phone
(973) 839-0220
Fax
(973) 839-4652
NPI assigned
Oct 6, 2006
Last updated
Mar 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00296800 NJ Primary

Addresses

Primary practice location

1817 Hamburg Tpke
Wayne, NJ 07470-6217

Mailing address

1817 Hamburg Tpke
Wayne, NJ 07470-6217
Phone (973) 839-0220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070418000271 NJ Practitioner - Chiropractic 6305941477 Practice locations: Wayne, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1817 Hamburg Tpke
Wayne, NJ 07470-6217
Phone (973) 839-0220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1548357957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706217",
            "telephone_number": "973-839-0220",
            "fax_number": "973-839-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706217",
            "telephone_number": "973-839-0220",
            "fax_number": "973-839-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTERA",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00296800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.