KIMBERLY MATTINA – Acute Care Nurse Practitioner, NPI 1104231083
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,106 NURSE PRACTITIONER in MI
Provider Addresses for KIMBERLY MATTINA
53156 CRIPPLE CREEK DR
CHESTERFIELD, MI 480475960
Phone:
Type: Mailing
53156 Cripple Creek Dr
Chesterfield, MI 480475960
Phone: (248) 495-6857
Type: Location
26206 W 12 MILE RD STE 105
SOUTHFIELD, MI 480341799
Phone: (248) 200-3715
Type: Location
1 FORD PL STE 3A
DETROIT, MI 482023450
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $406.
Total Amount is formed as General ($406) + Research ($0) + Ownership ($0) = $406.
Last reported payment date: 2024-08-08 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($155).
Total Amount
$406
General + Research + Ownership
Payments
5
Total payment records
General Amount
$406
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Edwards Lifesciences Corporation | $155 |
| Chiesi USA, Inc. | $151 |
| Kestra Medical Technology Services, Inc. | $100 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-08-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220815001072 | I | Nurse Practitioner | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48047)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Gastroenterology, Internal Medicine | PA | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Clinical Social Worker | MI | |
| - | MI | |
| Physician Assistant | MI | |
| Qualified Audiologist | MI | |
| O P H T H A L M O L O G Y | MI | |
| - | MI | |
| - | MI |
Reviews
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