Tej K. Mattoo, M.D.

Primary specialty

Pediatric Nephrology PhysicianTaxonomy code 2080P0210X

License

068731 Issued in MI

Practice address

Childrens Hospital of Michigan
3901 Beaubien Blvd - Nephrology
Detroit, MI 48201

Phone

(313) 745-5604

Fax

(313) 966-0039

NPI assigned

Jun 1, 2006

Sex

Male

Sole proprietor

No

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tmattoo@direct.dmc.org
• Direct secure messaging: tmattoo681949@direct.hfhs.org

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.

• Resilience Healthcare - Lakefront Medical Associates, LLC

  • General Practice Physician
  • Chicago, IL
  • NPI 1205301926
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1790722353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 ST. ANTOINE - UHC 5D MAILBOX 226",
            "address_2": "UNIVERSITY PEDIATRICIANS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4405",
            "fax_number": "313-966-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHILDRENS HOSPITAL OF MICHIGAN",
            "address_2": "3901 BEAUBIEN BLVD - NEPHROLOGY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-5604",
            "fax_number": "313-966-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOO",
        "first_name": "TEJ",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "MI",
            "license": "068731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Matthews
• Alison Joy Matthys, MD
• Nadin Matti, DNP
• Nadine Matti
• Nancy Mattman, CNP
• Ahmad Hatem Mattour, M.D.
• Dolores Mattox, RN
• Jeni Matuja
• Mature Matters, LLC
• Birgit Matyssek, RRT

• Pediatric Nephrology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Pediatric Nephrology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.