DR. ANDREA MARY MATTISON (DPT) – Pediatric Physical Therapist, NPI 1497205108

DR. ANDREA MARY MATTISON (DPT) is a healthcare provider. based in Saint paul, Minnesota. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 10362 (MN). The NPI Number for DR. ANDREA MARY MATTISON (DPT) is 1497205108

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
DR. ANDREA MARY MATTISON (DPT)
NPI
1497205108
Phone
(651) 773-0354
Address
2399 ARIEL ST #A
Enumeration Date
5 October 2016
Last Update Date
7 February 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8774073422
Graduation Year
2016 (10 years ago)
PAC ID
4284914672
Group Practice PAC ID
0941542591
Professional Enrollment ID
I20161130001659
Address ID
MN55305XXXXMIXXXXXXXXXX00
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

2,109 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MN

Provider Addresses for DR. ANDREA MARY MATTISON (DPT)

  • 2399 ARIEL ST #A

    SAINT PAUL, MN 551082202

    Phone: (651) 773-0354

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2016-11-30

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20161130001659IPhysical Therapist In Private PracticeMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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 55108)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941542591View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeNJ
Qualified Speech Language PathologistMN
Occupational Therapist In Private PracticeNJ
Physical Therapist In Private PracticeMN
Qualified Speech Language PathologistMN
Qualified Speech Language PathologistWI
Physical Therapist In Private PracticeWI
-MN
Physical Therapist In Private PracticeNJ
-MN

Reviews

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Frequently asked questions

What NPI should I save for DR. ANDREA MARY MATTISON (DPT)?
Save NPI 1497205108 if you need a stable reference for DR. ANDREA MARY MATTISON (DPT).
Is DR. ANDREA MARY MATTISON (DPT)'s NPI currently valid?
The extract we use shows DR. ANDREA MARY MATTISON (DPT) as active.
Does DR. ANDREA MARY MATTISON (DPT) list a primary specialty?
If you are matching referrals, note Pediatric Physical Therapist for DR. ANDREA MARY MATTISON (DPT). Clinical services aligned with this taxonomy classification.
Does DR. ANDREA MARY MATTISON (DPT) practice in Minnesota?
You will see Saint Paul, Minnesota on file for DR. ANDREA MARY MATTISON (DPT) alongside any extra practice locations.
What if Saint Paul, Minnesota seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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