Ryan J Mattek, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3229-57 Issued in WI

Practice address

6650 W State St
Suite 156
Wauwatosa, WI 53213-2827

Phone

(414) 491-0854

NPI assigned

Dec 8, 2014

Last updated

Apr 6, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1780082701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 W STATE ST",
            "address_2": "SUITE 156",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132827",
            "telephone_number": "414-491-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 W STATE ST",
            "address_2": "SUITE 156",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132827",
            "telephone_number": "414-491-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTEK",
        "first_name": "RYAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-08",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3229-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.