KATIE ANN MATTILA NP
NPI 1124891858
Nurse Practitioner in Grand Rapids, MI

Q: What is Katie Mattila's NPI number?

The NPI number for Katie Mattila is 1124891858. It was assigned to this individual provider in the NPPES registry on November 3, 2023. The provider is also known as Katie Ann Longenecker.

Q: What is Katie Mattila's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Katie Mattila was last updated on May 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 03, 2023PECOS Enrolled

790 FULLER AVE NE, GRAND RAPIDS, MI 49503(616) 336-3909(616) 336-8830 Get Directions Write a Review

NPPES record last updated: May 29, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 29, 2026, Jun 27, 2025, Nov 3, 2023 (3 updates tracked since 2023).

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About Katie Ann Mattila Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATIE ANN MATTILA NP (NPI 1124891858) is an individual nurse practitioner in Grand Rapids, Michigan, licensed in Minnesota (11177) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1124891858

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameKATIE ANN MATTILACredential: NP

Location Address790 FULLER AVE NEGrand Rapids, MI 49503-1918

Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074

Phone(616) 336-3909

Fax(616) 336-8830

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateNovember 3, 2023

Last NPPES UpdateMay 29, 20263 updates tracked since enumeration

NPPES CertifiedMay 29, 2026

✔ NPI 1124891858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MN · 11177

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License 204623 (ND)

790 FULLER AVE NE, Grand Rapids, MI 49503

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Other Names 1

Former Name (1)Katie Ann Longenecker

Secondary Practice Locations 2

Location 14820 23rd Ave SFargo, ND 58104-9137 · Phone (469) 677-7430

Location 2200 1st St SWRochester, MN 55905-0001 · Phone (507) 284-2511

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katie Ann Mattila Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3173976453

PECOS Enrollment IDI20250716000549

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

28 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIANA DUARTE-MENENDEZ LMSW

Social Worker (Clinical)