Active NPI
Richard E Mattison, M.D.
- Child & Adolescent Psychiatry Physician
- Hershey, PA
National Provider Identifier
1801827399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- MD024351E
- Practice address
- 22 Northeast Dr
Hershey, PA 17033-2732 - Phone
- (717) 531-8338
- Fax
- (717) 531-6250
- NPI assigned
- Jul 5, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD024351E | PA | |
| Psychiatry Physician | 2084P0800X | 118940 | NY | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD024351E | PA | Primary |
Addresses
Primary practice location
22 Northeast Dr
Hershey, PA 17033-2732
Mailing address
500 University Dr
Hershey, PA 17033-2360
Phone (800) 243-1455
Other practice location 1
500 University Dr
Hershey, PA 17033-2360
Phone (800) 243-1455
Other practice location 2
2501 N 3rd St
Harrisburg, PA 17110-1904
Phone (717) 782-6420
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01981222 | Medicaid | NY | |
| 102840870 | Medicaid | PA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rmattison@direct.psu.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD024351E | PA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stony Brook Psychiatric Associates, University Faculty Practice Corpor | Psychiatry | Past | Accepting new patients |
| Neurology Associates of Stony Brook, University Faculty Practice Corpo | 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 and National Provider Directory roles.
-
- Neurology Physician
- Stony Brook, NY
- NPI 1699720888
-
- Psychiatry Physician
- Stony Brook, NY
- NPI 1437105905
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618272000000",
"number": "1801827399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 UNIVERSITY DR",
"city": "HERSHEY",
"state": "PA",
"postal_code": "170332360",
"telephone_number": "800-243-1455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 NORTHEAST DR",
"city": "HERSHEY",
"state": "PA",
"postal_code": "170332732",
"telephone_number": "717-531-8338",
"fax_number": "717-531-6250"
}
],
"practiceLocations": [
{
"address_1": "500 University Dr",
"address_purpose": "LOCATION",
"city": "Hershey",
"state": "PA",
"postal_code": "170332360",
"country_code": "US",
"telephone_number": "800-243-1455",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2501 N 3rd St",
"address_purpose": "LOCATION",
"city": "Harrisburg",
"state": "PA",
"postal_code": "171101904",
"country_code": "US",
"telephone_number": "717-782-6420",
"fax_number": "717-782-4727",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATTISON",
"first_name": "RICHARD",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2021-04-13",
"certification_date": "2021-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD024351E",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "118940",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "PA",
"license": "MD024351E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01981222",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102840870",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rmattison@direct.psu.edu",
"affiliation": "N",
"endpointDescription": "direct email",
"address_1": "500 University Dr",
"city": "Hershey",
"state": "PA",
"country_code": "US",
"postal_code": "170332360",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Hershey, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.