Elie Matta, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302411941 Issued in MI

Practice address

5851 Mercury Dr
Dearborn, MI 48126-4161

Phone

(313) 441-0194

NPI assigned

Aug 28, 2019

Last updated

Aug 28, 2019By 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 Pharmacy

State licenses

Practice roles

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.

• Assisted Health Services LLC

  • In Home Supportive Care Agency
  • Dearborn, MI
  • NPI 1730988411
  NPD Authorized official

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1922656321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5438 HARTWELL ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263311",
            "telephone_number": "313-717-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5851 MERCURY DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264161",
            "telephone_number": "313-441-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTA",
        "first_name": "ELIE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302411941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter William Mathis
• Susan G Matlas, LMSW, LMFT
• Fabrice Ngufor Matoyah
• Amy Matschikowski
• Amira Matta
• Ashley Mattern
• Celeste Monique Matthews
• Rachel McLaurin Matthews
• Talaya Matthews
• Maggie Matthewson, R.D.H. B.S.

• Pharmacist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.