NPIMap

Individual provider Active NPI

Nicolette Crystal Matteau, PA-C

  • Physician Assistant
  • Berwick, ME
National Provider Identifier
1003485285
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2195 Issued in ME
Practice address
4 Dana LN
Berwick, ME 03901-2767
Phone
(207) 698-6700
NPI assigned
Jun 22, 2021
Last updated
Sep 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA2195 ME Primary

Addresses

Primary practice location

4 Dana LN
Berwick, ME 03901-2767

Mailing address

15 Hospital Dr
York, ME 03909-1099
Phone (072) 363-4321

Other practice location 1

25A June St Ste 11
Sanford, ME 04073-2642
Phone (207) 490-7900

Other names 1

  • Nicolette Crystal Matteay Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922003070 ME Practitioner - Physician Assistant 2668879354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of New England, College of Osteo Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

9 Healthcare Dr
Biddeford, ME 04005-9449
Phone (207) 283-0998

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA2195MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Aug 15, 2022 Accepting new patients
Seacoast Pathology Inc Current Accepting new patients
Mainehealth CurrentSince Aug 15, 2022 Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

655 Main St
Saco, ME 04072
Phone (207) 283-1407

25A June St
Ste 11
Sanford, ME 04073
Phone (207) 282-3666

15 Hospital Dr
York, ME 03909
Phone (207) 351-2478

Interoperability endpoints

  • Direct secure messaging: nmatteau121501@direct.mmc.mainehealth.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1003485285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 HOSPITAL DR",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039091099",
            "telephone_number": "072-363-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 DANA LN",
            "city": "BERWICK",
            "state": "ME",
            "postal_code": "039012767",
            "telephone_number": "207-698-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25A June St Ste 11",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "ME",
            "postal_code": "040732642",
            "country_code": "US",
            "telephone_number": "207-490-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTEAU",
        "first_name": "NICOLETTE",
        "middle_name": "CRYSTAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLETTE",
            "last_name": "MATTEAY",
            "middle_name": "CRYSTAL",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Berwick, ME

Sources for this page

Verify at the official NPI Registry.