Individual provider Active NPI

Cathleen Ditton Mattos, DC

  • Chiropractor
  • East Stroudsburg, PA
National Provider Identifier
1962519173
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-006904-R Issued in PA
Practice address
8 Fox Run Lane
East Stroudsburg, PA 18301
Phone
(570) 223-1650
Fax
(570) 223-8235
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-006904-R PA Primary

Addresses

Primary practice location

8 Fox Run Lane
East Stroudsburg, PA 18301

Mailing address

8 Fox Run Lane
East Stroudsburg, PA 18301
Phone (570) 223-1650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150501000564 PA Practitioner - Chiropractic 7012236755 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-006904-RPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa Pathak MD LLC CurrentSince Jun 1, 2015 Accepting new patients
Lehigh Valley Hospital Pocono Past Accepting new patients

Locations

1592 Route 739
Dingmans Fry, PA 18328
Phone (570) 828-1900

1592 Route 739
Ste 1
Dingmans Fry, PA 18328
Phone (570) 828-8000

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.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962519173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 FOX RUN LANE",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "18301",
            "telephone_number": "570-223-1650",
            "fax_number": "570-223-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 FOX RUN LANE",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "18301",
            "telephone_number": "570-223-1650",
            "fax_number": "570-223-8235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOS",
        "first_name": "CATHLEEN",
        "middle_name": "DITTON",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC-006904-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.