DR. RONALD EDWIN MATTISON (M.D.) – Surgery Physician, NPI 1396723748

DR. RONALD EDWIN MATTISON (M.D.) is a healthcare provider. based in Memphis, Tennessee. specializing in GENERAL SURGERY. They hold the professional credentials M.D.. They hold a License No. 048275 (GA). The NPI Number for DR. RONALD EDWIN MATTISON (M.D.) is 1396723748

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
DR. RONALD EDWIN MATTISON (M.D.)
NPI
1396723748
Phone
(901) 527-3391
Address
6005 PARK AVE
Enumeration Date
5 January 2006
Last Update Date
15 September 2010

Doctor Profile

Medical School Name
MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Secondary Phone
7704284486
Graduation Year
1993 (33 years ago)
PAC ID
9436107505
Group Practice PAC ID
9931180098
Professional Enrollment ID
I20160204001981
Address ID
GA301061122AU1790XRDXX316
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness75
Years active:20State licenses:3Digital endpointsOther names

860 GENERAL SURGERY in TN

Loading map...

Provider Addresses for DR. RONALD EDWIN MATTISON (M.D.)

  • 6005, Park Avenue, White Station, Memphis, Shelby County, Tennessee, 38119, United States

    SUITE 700

    MEMPHIS, TN 381195202

    Phone: (901) 527-3391

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2016-02-04

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
I20160204001981IGeneral SurgeryGATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes1,007887$0
76642Limited ultrasound scan of 1 breast797545$0
99214Established patient office or other outpatient visit, 30-39 minutes503324$0
76641Complete ultrasound scan of 1 breast178149$0
99204New patient office or other outpatient visit, 45-59 minutes7676$0
View full utilization report →

Insurance plans in this area (ZIP 38119)

Loading plans...

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: 9931180098View full group profile
NameSpecialtyState
General Surgery, Surgical OncologyGA
General SurgeryGA
General SurgeryGA

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the 10-digit NPI for DR. RONALD EDWIN MATTISON (M.D.)?
DR. RONALD EDWIN MATTISON (M.D.) — NPI 1396723748 — is the standard way to identify this listing.
Does the file indicate DR. RONALD EDWIN MATTISON (M.D.) is practicing under active NPI?
Directory data currently reports DR. RONALD EDWIN MATTISON (M.D.) as active.
What is DR. RONALD EDWIN MATTISON (M.D.)'s primary classification?
Surgery Physician is the headline specialty for DR. RONALD EDWIN MATTISON (M.D.) here. Clinical services aligned with this taxonomy classification.
What area does DR. RONALD EDWIN MATTISON (M.D.) serve?
DR. RONALD EDWIN MATTISON (M.D.)'s listing highlights Memphis, Tennessee; more addresses can appear in NPPES.
Is the information about DR. RONALD EDWIN MATTISON (M.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

Similar Providers

DR. BHASKAR N RAO (MD)

Surgery Physician
St. Jude Children's Research Hospital, 262, Danny Thomas Place, Lauderdale Courts, Memphis, Shelby County, Tennessee, 38105, United States
NPI: 1518960913

DR. JOSE G MEJIA (MD)

Surgery Physician
Health First Business Center (Bldg A), 3300, South Fiske Boulevard, Rockledge, Brevard County, Florida, 32955, United States
NPI: 1679573638
1264, Wesley Drive, Whitehaven, Memphis, Shelby County, Tennessee, 38116, United States
NPI: 1467453720

GABOR A. WINKLER (MD)

Vascular Surgery Physician
1375 W BRIERBROOK RD
NPI: 1558362970

UT MEDICAL GROUP INC

Multi-Specialty Clinic/Center
1068 CRESTHAVEN RD STE 300
NPI: 1780676650

LUAN CONG TRAN (MD MPH)

Surgery Physician
1222, South Patterson Boulevard, Dayton, Montgomery County, Ohio, 45409, United States
NPI: 1619967650

DR. DANIELLE GOTTLIEB SEN (MD MPH MS)

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2200 Childrens Way Ste 7102
NPI: 1518958107

DR. WILLIAM G CLOUD (MD)

Surgery Physician
Ridge Lake Boulevard, White Station, Memphis, Shelby County, Tennessee, 38120, United States
NPI: 1912988346