Individual provider Active NPI

Kevin B Al-Mateen, MD

  • Neonatal-Perinatal Medicine Physician
  • Spring, TX
National Provider Identifier
1033188024
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
Q2875 Issued in TX
Practice address
6620 Cypresswood Dr
Spring, TX 77379-7746
Phone
(281) 477-8660
Fax
(281) 477-8662
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101046916 VA
Neonatal-Perinatal Medicine Physician 2080N0001X 0101046916 VA
Neonatal-Perinatal Medicine Physician 2080N0001X Q2875 TX Primary

Addresses

Primary practice location

6620 Cypresswood Dr
Spring, TX 77379-7746

Mailing address

6620 Cypresswood Dr
Spring, TX 77379-7746
Phone (281) 477-8660

Other identifiers 2

IdentifierTypeStateIssuer
010072301MedicaidVA
342573802MedicaidTX

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q2875TXMDNeonatal-Perinatal Medicine Physician
0101046916VAMDNeonatal-Perinatal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1033188024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 CYPRESSWOOD DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773797746",
            "telephone_number": "281-477-8660",
            "fax_number": "281-477-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 CYPRESSWOOD DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773797746",
            "telephone_number": "281-477-8660",
            "fax_number": "281-477-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-MATEEN",
        "first_name": "KEVIN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101046916",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "VA",
            "license": "0101046916",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "Q2875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010072301",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342573802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.