Individual provider Active NPI

Anissa R Mattison, D.O.

  • Obstetrics & Gynecology Physician
  • Rochester Hills, MI
National Provider Identifier
1972605863
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
AM014591 Issued in MI
Practice address
1812 S Rochester Rd
Rochester Hills, MI 48307-3532
Phone
(248) 656-9100
Fax
(248) 656-9157
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
No

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.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
76.43 of 100Reported as group
Quality
84.93
Improvement activities
0
Cost
73.5

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20070914000680 MI Practitioner - Obstetrics/Gynecology 3577593235 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
AM014591MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJMH Medical Practice-SMHC Obstetrics & Gynecology CurrentSince Sep 10, 2007 Accepting new patients
SJMH Medical Practice-SMHC CurrentSince Sep 10, 2007 Accepting new patients

Locations

44428 Woodward Ave
Ste 101
Pontiac, MI 48341

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

44428 Woodward Ave
Ste 104
Pontiac, MI 48341
Phone (248) 858-6272

1812 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 656-3515

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X AM014591 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

1812 S Rochester Rd
Rochester Hills, MI 48307-3532

Mailing address

1812 S Rochester Rd
Rochester Hills, MI 48307-3532
Phone (248) 656-9100

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 5, 2007.

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1972605863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 S ROCHESTER RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073532",
            "telephone_number": "248-656-9100",
            "fax_number": "248-656-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 S ROCHESTER RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073532",
            "telephone_number": "248-656-9100",
            "fax_number": "248-656-9157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTISON",
        "first_name": "ANISSA",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "AM014591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.