Mark Sean Mattingly, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN560464 Issued in PA

Practice address

230 N Broad St
Philadelphia, PA 19102-1121

Phone

(215) 762-7922

Fax

(215) 762-8656

NPI assigned

Oct 3, 2005

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

Enrolled in PA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/0d26bd04-9128-4f58-8e6d-ffda5cd00f89/

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.

• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675
  Medicare reassignment Care Compare group NPD
• Associates in Anesthesia, Inc.

  • Anesthesiology Physician
  • Chadds Ford, PA
  • NPI 1942281191
  Medicare reassignment NPD
• Rancocas Anesthesiology, P.a.

  • Specialist
  • Mount Laurel, NJ
  • NPI 1427076553

  PA

  Medicare reassignment NPD
• Associates in Anesthesia

  • Anesthesiology Physician
  • Chadds Ford, PA
  • NPI 1336470467
  NPD (past)
• Medical Anesthesia Group, PA

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1679527501
  NPD (past)

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

• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400198400000",
    "number": "1962499293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MARKET ST",
            "address_2": "24TH FLOOR-WEST TOWER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022100",
            "telephone_number": "215-255-3828",
            "fax_number": "215-255-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-762-7922",
            "fax_number": "215-762-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "MARK",
        "middle_name": "SEAN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2014-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN560464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamia Matthews, CRNP
• Isaac Crane Matthias, MD
• Alexandra Marie Mattia
• Christopher Mattiello, DO
• Marja Elina Mattila-Evenden, MD
• Billie Mattioli
• Maria Mattioli, APRN
• Jaeda Mattis, DO
• Robert Eric Mattson, PH.D.
• Shawn Mattson, M.D.

• Certified Registered Nurse Anesthetist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Certified Registered Nurse Anesthetist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.