Individual provider Active NPI

Lisa L Mattke, CNM

  • Advanced Practice Midwife
  • Albuquerque, NM
National Provider Identifier
1790754737
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
620 Issued in NM
Practice address
201 Cedar St SE
Ste. 5640
Albuquerque, NM 87106-4917
Phone
(505) 843-6168
Fax
(505) 247-9743
NPI assigned
Mar 14, 2006
Last updated
Apr 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 41345 TN
Midwife 176B00000X R148101-3 MN
Advanced Practice Midwife 367A00000X 620 NM Primary

Addresses

Primary practice location

201 Cedar St SE
Ste. 5640
Albuquerque, NM 87106-4917

Mailing address

201 Cedar St SE
Ste. 5640
Albuquerque, NM 87106-4917
Phone (505) 843-6168

Other practice location 1

1511 Gunbarrel Rd Ste 111
Chattanooga, TN 37421-3897
Phone (423) 553-5999

Other identifiers 1

IdentifierTypeStateIssuer
86807331MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260527002996 TN Practitioner - Certified Nurse Midwife (CNM) 1355375916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Oregon Health Sciences University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

137 Thistleton Way
St Augustine, FL 32092-3281

300 Stonecrest Blvd
Suite 310
Smyrna, TN 37167-5684

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R148101-3MNMDMidwife
41345TNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1790754737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 CEDAR ST SE",
            "address_2": "STE. 5640",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064917",
            "telephone_number": "505-843-6168",
            "fax_number": "505-247-9743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CEDAR ST SE",
            "address_2": "STE. 5640",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064917",
            "telephone_number": "505-843-6168",
            "fax_number": "505-247-9743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1511 Gunbarrel Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374213897",
            "country_code": "US",
            "telephone_number": "423-553-5999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTKE",
        "first_name": "LISA",
        "middle_name": "L",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TN",
            "license": "41345",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "MN",
            "license": "R148101-3",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NM",
            "license": "620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86807331",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.