Individual provider Active NPI

John Mattarella, CRNA

  • Certified Registered Nurse Anesthetist
  • Livonia, MI
National Provider Identifier
1720068166
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704134134 Issued in MI
Practice address
35220 Curtis Rd
Livonia, MI 48152-2900
Phone
(734) 241-3891
Fax
(734) 241-0014
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont West Bloomfield ASC LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Beaumont Macomb Township ASC, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704134134 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

35220 Curtis Rd
Livonia, MI 48152-2900

Mailing address

35220 Curtis Rd
Livonia, MI 48152-2900
Phone (734) 241-3891

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 13, 2026.

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720068166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35220 CURTIS RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522900",
            "telephone_number": "734-241-3891",
            "fax_number": "734-241-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35220 CURTIS RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522900",
            "telephone_number": "734-241-3891",
            "fax_number": "734-241-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTARELLA",
        "first_name": "JOHN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704134134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.