Individual provider Active NPI

Evan Mattice

  • Audiologist
  • Dallas, TX
National Provider Identifier
1700314614
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
7777 Forest LN Ste A107
Dallas, TX 75230-6872
Phone
(972) 566-7359
NPI assigned
May 23, 2017
Last updated
May 23, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X NU Primary

Addresses

Primary practice location

7777 Forest LN Ste A107
Dallas, TX 75230-6872

Mailing address

7777 Forest LN Ste A107
Dallas, TX 75230-6872

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170731001105 TX Practitioner - Qualified Audiologist 6901177666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas Otolaryngology AssociatesGroup PAC ID 3072647890, 19 clinicians

Practice addresses (Care Compare)

7777 Forest LN
Suite A103
Dallas, TX 75230-6800
Phone (972) 566-7600

Merit-based Incentive Payment System (MIPS)

Final score
84.22 of 100Reported as group
Quality
82.14
Improvement activities
40
Cost
71.2

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Otolaryngology Associates CurrentSince Jun 28, 2017 Accepting new patients

Locations

7777 Forest Ln
Ste A103
Dallas, TX 75230
Phone (972) 566-7359

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.

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495497600000",
    "number": "1700314614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE A107",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE A107",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306872",
            "telephone_number": "972-566-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTICE",
        "first_name": "EVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2017-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; 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.