Active NPI
Stephen Matteson, PHD
- Psychologist
- Muncie, IN
National Provider Identifier
1740895887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 2525 W University Ave Ste 401
Muncie, IN 47303-3433 - Phone
- (765) 747-4306
- NPI assigned
- Sep 15, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
2525 W University Ave Ste 401
Muncie, IN 47303-3433
Mailing address
2525 W University Ave Ste 401
Muncie, IN 47303-3433
Phone (765) 747-4306
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The South Bend Clinic, LLC | Current | Accepting new patients | |
| The South Bend Clinic LLC | Current | Accepting new patients |
Locations
52500 Fir Rd
Granger, IN 46530
Phone (574) 204-7050
211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331
6301 University Commons
Ste 230
South Bend, IN 46635
Phone (574) 251-2115
Interoperability endpoints
- https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/
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.
-
- Clinic/Center
- South Bend, IN
- NPI 1073680419
-
- Anesthesiology Physician
- South Bend, IN
- NPI 1487307492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600128000000",
"number": "1740895887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 W UNIVERSITY AVE STE 401",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473033433",
"telephone_number": "765-747-4306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 W UNIVERSITY AVE STE 401",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473033433",
"telephone_number": "765-747-4306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTESON",
"first_name": "STEPHEN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-15",
"last_updated": "2020-09-15",
"certification_date": "2020-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.