Active NPI
Nicolette Crystal Matteau, PA-C
- Physician Assistant
- Berwick, ME
National Provider Identifier
1003485285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2195
- Practice address
- 4 Dana LN
Berwick, ME 03901-2767 - Phone
- (207) 698-6700
- NPI assigned
- Jun 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Mainehealth
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
- Mainehealth Maine Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.93 of 100
- Quality
- 83.31
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.93 of 100
- Quality
- 83.31
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2195 | ME | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seacoast Pathology Inc | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | 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
- 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Family Medicine Physician
- Portland, ME
- NPI 1629761978
-
- Clinical Medical Laboratory
- Exeter, NH
- NPI 1154651230
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.