Fallon Andrea Mattis, MD is a medicare enrolled "Family Medicine" physician in South Boston, Virginia. She went to University Of Pittsburgh School Of Medicine and graduated in 2010 and has 14 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Doctor On Demand Professionals Of New Jersey Pc and her current practice location is
101 Aubreys Loop, Sentara Halifax Family Medicine, South Boston, Virginia. You can reach out to her office (for appointments etc.) via phone at
(646) 835-9001.
Fallon Andrea Mattis is licensed to practice in Virginia (license number 0101257845) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1558686345.
Physician's Profile
| Full Name | Fallon Andrea Mattis |
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| Gender | Female |
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| Speciality | Family Practice |
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| Experience | 14 Years |
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| Location | 101 Aubreys Loop, South Boston, Virginia |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Fallon Andrea Mattis attended and graduated from University Of Pittsburgh School Of Medicine in 2010
NPI Data:
- NPI Number: 1558686345
- Provider Enumeration Date: 04/05/2010
- Last Update Date: 10/30/2019
Medicare PECOS Information:
- PECOS PAC ID: 3678885043
- Enrollment ID: I20200514000776
Medical Identifiers
Medical identifiers for Fallon Andrea Mattis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1558686345 | NPI | - | NPPES |
| 1558686345 | Other | NY | FAMILY MEDICINE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | R7061 (Texas) | Secondary |
| 207Q00000X | Family Medicine | 63188 (Minnesota) | Secondary |
| 207Q00000X | Family Medicine | 036144488 (Illinois) | Secondary |
| 207Q00000X | Family Medicine | 2017034134 (Missouri) | Secondary |
| 207Q00000X | Family Medicine | 10501937-1205 (Utah) | Secondary |
| 207Q00000X | Family Medicine | 273617-1 (New York) | Secondary |
| 207Q00000X | Family Medicine | 25MA10713600 (New Jersey) | Secondary |
| 207Q00000X | Family Medicine | 0101257845 (Virginia) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Doctor On Demand Professionals Of New Jersey Pc | 3476835851 | 15 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Fallon Andrea Mattis allows following entities to bill medicare on her behalf.
| Entity Name | Doctor On Demand Professionals Of New Jersey Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1689082950
PECOS PAC ID: 3476835851
Enrollment ID: O20200514000642 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Fallon Andrea Mattis is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Fallon Andrea Mattis, MD
1103 N Main St,
South Boston, VA 24592-2511
Ph: (646) 835-9001 | Fallon Andrea Mattis, MD
101 Aubreys Loop, Sentara Halifax Family Medicine,
South Boston, VA 24592-5054
Ph: (646) 835-9001 |
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