Individual provider Active NPI

Carrie L. Mattoon, P.A.

  • Physician Assistant
  • Geneva, NY
National Provider Identifier
1649245457
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007913 Issued in NY
Practice address
200 North St Ste 101
Geneva, NY 14456-1561
Phone
(315) 787-5111
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 007913 NY Primary

Addresses

Primary practice location

200 North St Ste 101
Geneva, NY 14456-1561

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmattoon194733@direct.rochesterregional.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040618000260 NY Practitioner - Physician Assistant 7719961408 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

1415 Portland Ave
Rochester, NY 14621-3022

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-3122

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

200 N St
Geneva, NY 14456-1561
Phone (315) 787-5100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Mar 1, 2022 Accepting new patients
Rochester General Hospital CurrentSince Mar 1, 2022 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Sep 1, 2015 Accepting new patients
Clifton Springs Medical Service PLLC Past Accepting new patients

Locations

71 Kendall St
Clifton Springs, NY 14432
Phone (315) 462-0447

4 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1368

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

833 Canandaigua Rd
Geneva, NY 14456
Phone (315) 210-1331

200 North St
Ste 101
Geneva, NY 14456
Phone (315) 787-5100

1250 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2427

120 Erie Canal Dr
Ste 200
Rochester, NY 14626
Phone (585) 225-6680

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1415 Portland Ave
Ste 400
Rochester, NY 14621
Phone (585) 922-4200

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: cmattoon194733@direct.rochesterregional.org

Organizations & group practices 6

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 3

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1649245457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NORTH ST STE 101",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561561",
            "telephone_number": "315-787-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOON",
        "first_name": "CARRIE",
        "middle_name": "L.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmattoon194733@direct.rochesterregional.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 North St Ste 101",
            "city": "Geneva",
            "state": "NY",
            "country_code": "US",
            "postal_code": "144561561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

Verify at the official NPI Registry.