NPIMap

Individual provider Active NPI

Costy Mattar

  • Cardiovascular Disease Physician
  • Hutchinson, KS
National Provider Identifier
1780860411
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
04-37220 Issued in KS
Practice address
2101 N Waldron St
Hutchinson, KS 67502-1197
Phone
(620) 669-2500
Fax
(620) 663-5207
NPI assigned
Jan 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 04-37220 KS Primary

Addresses

Primary practice location

2101 N Waldron St
Hutchinson, KS 67502-1197

Mailing address

2101 N Waldron St
Hutchinson, KS 67502-1131
Phone (620) 669-2500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address costymattar@hcpa.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140520002073 KS Practitioner - Cardiovascular Disease (Cardiology) 2961697073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hutchinson Clinic PA IncGroup PAC ID 5597658492, 130 clinicians

Practice addresses (Care Compare)

2101 N Waldron St
Hutchinson, KS 67502-1131
Phone (620) 669-2500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting73
Pacemaker insertion or repair38
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-37220KSMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Clinic, P.a., Inc. Current Accepting new patients
Hutchinson Clinic, PA, Inc. CurrentSince Jul 15, 2014 Accepting new patients
Hutchinson Clinic, P.a. Inc. Current Accepting new patients
Heartland Radiation Oncology Current Accepting new patients
Hutchinson Clinic, P.a., Inc. Current Accepting new patients
Hutchinson Clinic, P.a., Inc. CurrentSince Jul 15, 2014 Accepting new patients

Locations

2101 N Waldron St
Hutchinson, KS 67502
Phone (620) 669-2500

619 N Main St
McPherson, KS 67460
Phone (620) 504-6530

Organizations & group practices 6

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1780860411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 N WALDRON ST",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675021131",
            "telephone_number": "620-669-2500",
            "fax_number": "620-663-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N WALDRON ST",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675021197",
            "telephone_number": "620-669-2500",
            "fax_number": "620-663-5207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTAR",
        "first_name": "COSTY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-11",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KS",
            "license": "04-37220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "costymattar@hcpa.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "HUTCHINSON CLINIC, PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2101 N Waldron St",
            "city": "Hutchinson",
            "state": "KS",
            "country_code": "US",
            "postal_code": "675021131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hutchinson, KS

Sources for this page

Verify at the official NPI Registry.