Individual provider Active NPI

Tamara Ann Matejka

  • Certified Registered Nurse Anesthetist
  • Asheville, NC
National Provider Identifier
1033387402
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
230674 Issued in NC
Practice address
76 Peachtree Road
Suite 300
Asheville, NC 28803-3505
Phone
(828) 274-3477
Fax
(828) 274-7407
NPI assigned
Feb 19, 2008
Last updated
Dec 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 079007 FL
Certified Registered Nurse Anesthetist 367500000X 230674 NC Primary

Addresses

Primary practice location

76 Peachtree Road
Suite 300
Asheville, NC 28803-3505

Mailing address

50 Schenck Pkwy
Suite 300
Asheville, NC 28803-3499
Phone (828) 681-1527

Other identifiers 1

IdentifierTypeStateIssuer
8053611MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160608000010 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547349318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
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

6 Glen Cove Dr
Rockport, ME 04856-4272
Phone (207) 921-8969

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
079007FLMDCertified Registered Nurse Anesthetist
230674NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth CurrentSince Apr 1, 2016 Accepting new patients

Locations

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

6 Glen Cove Dr
Rockport, ME 04856
Phone (207) 596-8000

Organizations & group practices 4

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 1

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": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1033387402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 SCHENCK PKWY",
            "address_2": "SUITE 300",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288033499",
            "telephone_number": "828-681-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 PEACHTREE ROAD",
            "address_2": "SUITE 300",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288033505",
            "telephone_number": "828-274-3477",
            "fax_number": "828-274-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEJKA",
        "first_name": "TAMARA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "079007",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "230674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8053611",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.