LISA R MATTSON (NPI# 1053394825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053394825 |
| Entity Type | Individual |
| Full Name | LISA R MATTSON |
| Credential | M.D. |
| Practice Address |
500 Osborne Rd Ne Suite 255 Fridley MN 55432-2765 |
| Mailing Address |
2925 Chicago Ave Minneapolis MN 55407-1321 |
| Practice Telephone | 7632362500 |
| Practice Fax Number | 7632362505 |
| Mailing Telephone | 6122625000 |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2011-12-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 38249 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 676019800 | 05 |
| Street Address |
500 OSBORNE RD NE SUITE 255 |
| City | FRIDLEY |
| State | MN |
| Zip Code | 55432-2765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407851694 | Crystal M Dexter | Family Medicine | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2774 | 2005-06-15 |
| 1083152367 | Angela Bennett | Pediatrics | 500 Osborne Rd Ne, Suite 215, Fridley, MN 55432-2765 | 2017-02-07 |
| 1902263866 | Jennifer Alma Wilson | Registered Nurse | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2774 | 2016-01-24 |
| 1689067860 | Mona Abdel-bary | Family Medicine | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2765 | 2015-03-11 |
| 1073935219 | Jill Marrone | Dietitian, Registered | 500 Osborne Rd Ne, Suite 200, Fridley, MN 55432-2765 | 2014-01-07 |
| 1164844304 | Michelle Mezera | Dietitian, Registered | 500 Osborne Rd Ne, Suite 200, Fridley, MN 55432-2765 | 2014-01-07 |
| 1720315567 | Cities Lung Clinic Pa | Internal Medicine | 500 Osborne Rd Ne, Suite 360, Fridley, MN 55432-2783 | 2009-11-16 |
| 1932341252 | Lucie Larson | Obstetrics & Gynecology | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2765 | 2009-04-01 |
| 1437399250 | Advanced Cosmetic & Plastic Surgery | Specialist | 500 Osborne Rd Ne, Suite 130, Fridley, MN 55432-2765 | 2009-03-06 |
| 1255588299 | Metropolitan Cardiology Consultants | Specialist | 500 Osborne Rd Ne, Suite 120, Fridley, MN 55432-2765 | 2008-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
| 1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
| 1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
| 1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
| 1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
| 1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
| Find all providers in zip 55432 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831213438 | Henry Kah Min Bong | Obstetrics & Gynecology | 500 Osborne Rd, #110, Fridley, MN 55432 | 2007-03-19 |
| 1669433207 | Cecil Emerson Bassett | Obstetrics & Gynecology | 6401 University Ave Ne, Fridley, MN 55432-4341 | 2006-03-31 |
| 1275528671 | Multicare Associates of The Twin Cities,pa | Obstetrics & Gynecology | 480 Osborne Rd Ne, Suite 100, Fridley, MN 55432-2773 | 2005-09-13 |
| 1932341252 | Lucie Larson | Obstetrics & Gynecology | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2765 | 2009-04-01 |
| 1780794842 | Cheryl Lynn Cody Deets | Obstetrics & Gynecology | 500 Osborne Rd Ne, Suite 150, Fridley, MN 55432-2765 | 2006-08-30 |
| 1649236894 | Nicholas W Hamel | Obstetrics & Gynecology | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2765 | 2006-04-25 |
| 1932163607 | Pamela Green | Obstetrics & Gynecology | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2765 | 2006-04-12 |
| 1407818073 | Lex Lawson | Obstetrics & Gynecology | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2765 | 2006-04-06 |
| 1861452740 | Keith Thomas Wenda | Obstetrics & Gynecology | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2765 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316581218 | Catherine Pamela Edwards | Obstetrics & Gynecology | 7048 Highover Ct S, Chanhassen, MN 55317-7569 | 2019-11-04 |
| 1407329139 | Arthur Joseph Horowitz | Obstetrics & Gynecology | 830 Edgemoor Dr, Hopkins, MN 55305-4852 | 2019-01-04 |
| 1710437967 | David Olson | Obstetrics & Gynecology | 8201 Creekside Cir, Bloomington, MN 55437-3836 | 2016-10-12 |
| 1326492182 | Leah Christine Henke | Obstetrics & Gynecology | 688 Holly Ave Apt 5, Saint Paul, MN 55104-7557 | 2016-04-19 |
| 1922402395 | Robert Ross Neal Jr. | Obstetrics & Gynecology | 7917 Wyoming Ct, Bloomington, MN 55438-1092 | 2014-10-14 |
| 1285052027 | Paige Persch | Obstetrics & Gynecology | 6565 France Ave S Ste 300, Edina, MN 55435-2154 | 2014-03-30 |
| 1386065100 | Jennifer Arnhold Md Plc | Obstetrics & Gynecology | 13359 Isle Dr. Suite 2, Baxter, MN 56425-2222 | 2013-12-20 |
| 1598008716 | Sarah Marie Krueger | Obstetrics & Gynecology | 606 24th Ave S Ste 700, Minneapolis, MN 55454-1462 | 2013-04-05 |
| 1922341791 | Matthew Thomas Bigos | Obstetrics & Gynecology | 14001 Ridgedale Dr Ste 200, Minnetonka, MN 55305-1747 | 2013-03-31 |
| 1205191335 | William F Dickes | Obstetrics & Gynecology | 14708 57th St S, Afton, MN 55001-9686 | 2012-07-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.