Active NPI
Kelly Maureen Maton, M.D.
- Neurology Physician
- Palmetto Bay, FL
National Provider Identifier
1013901263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 218931
- Practice address
- 17615 SW 97TH Ave
Palmetto Bay, FL 33157-5636 - Phone
- (786) 624-5955
- Fax
- (786) 268-1738
- NPI assigned
- Sep 2, 2005
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 218931 | NY | |
| Neurology Physician | 2084N0400X | 218931 | NY | Primary |
Addresses
Primary practice location
17615 SW 97TH Ave
Palmetto Bay, FL 33157-5636
Mailing address
3200 SW 60TH CT.
Suite#302
Miami, FL 33155-4071
Phone (305) 622-8330
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02097661 | Medicaid | NY |
Other names 1
- Kelly Maureen O'Neill
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 218931 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Neurology Associates, P.a. | Neurology | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193443200000",
"number": "1013901263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 SW 60TH CT.",
"address_2": "SUITE#302",
"city": "MIAMI",
"state": "FL",
"postal_code": "331554071",
"telephone_number": "305-622-8330",
"fax_number": "305-669-6496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17615 SW 97TH AVE",
"city": "PALMETTO BAY",
"state": "FL",
"postal_code": "331575636",
"telephone_number": "786-624-5955",
"fax_number": "786-268-1738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATON",
"first_name": "KELLY",
"middle_name": "MAUREEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-02",
"last_updated": "2007-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "218931",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "218931",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02097661",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "O'NEILL",
"middle_name": "MAUREEN",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Palmetto Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.