Dezeray Clare Matott, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6503-33 Issued in WI

Practice address

12961 27TH Ave
Chippewa Falls, WI 54729-5699

Phone

(715) 738-3700

NPI assigned

Jul 28, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Dezeray Clare Tomesh Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1649655952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12961 27TH AVE",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547295699",
            "telephone_number": "715-738-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12961 27TH AVE",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547295699",
            "telephone_number": "715-738-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOTT",
        "first_name": "DEZERAY",
        "middle_name": "CLARE",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6503-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEZERAY",
            "last_name": "TOMESH",
            "middle_name": "CLARE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marshfield Clinic
• Patricia Marsnik
• Andrew Peter Martin
• Maria Lynn Martino, DPT
• Emily J Mason, M.D.
• Daniel William McCann, MSW
• Terrence D McCanna, MD
• William A McDougall, MD
• Shawn M. McFarlane, DDS
• MCHS Hospitals Inc

• Family Nurse Practitioner in Chippewa Falls, WI
• Providers in Chippewa Falls, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.