MEDICARE: DR. THOMAS A MATTIONI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	20241	AZ
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	20241	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	060047024	OTHER	AZ	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	AZ0821440	OTHER	AZ	BCBS AZ
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4400898	OTHER	AZ	AETNA

General Provider Information

NPI Number	:	1750384665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS A MATTIONI M.D.

Provider Business Mailing Address
First Line	:	3225 N CIVIC CENTER PLZ
Second Line	:	SUITE 1
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-6919
Country	:	US
Telephone Number	:	480-246-3000
Fax Number	:	480-246-3100

Provider Business Practice Location Address
First Line	:	3225 N CIVIC CENTER PLZ
Second Line	:	SUITE 1
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-6919
Country	:	US
Telephone Number	:	480-246-3000
Fax Number	:	480-246-3100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/15/2014

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Directions to “ DR. THOMAS A MATTIONI M.D.” Practice Location

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