NPIMap

Individual provider Active NPI

Kristen Lee Matulis, DNP, APRN, AGNP-C

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1033767587
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
310775 Issued in NY
Practice address
710 W 168TH St RM 335
New York, NY 10032-3726
Phone
(972) 978-6478
Fax
(212) 305-1304
NPI assigned
Aug 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 11003829 FL
Adult Health Nurse Practitioner 363LA2200X 310775 NY Primary

Addresses

Primary practice location

710 W 168TH St RM 335
New York, NY 10032-3726

Mailing address

710 W 168TH St RM 335
New York, NY 10032-3726
Phone (972) 978-6478

Other identifiers 1

IdentifierTypeStateIssuer
104216100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221005001493 NY Practitioner - Nurse Practitioner 2860723996 Reassigns benefits to 1 organization
I20251028000002 TX Practitioner - Nurse Practitioner 2860723996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

8300 Floyd Curl Dr
San Antonio, TX 78229-3931
Phone (210) 450-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11003829FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio CurrentSince Sep 16, 2025 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 29, 2022 Accepting new patients
University of Texas Health Science Center at San Antonio Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 29, 2022 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Sep 16, 2025 Accepting new patients

Locations

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

710 W 168th St
Rm 1125A
New York, NY 10032

710 W 168th St
Rm 335
New York, NY 10032
Phone (972) 978-6478

8300 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-9300

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: kmatulis66872@direct.utmsa.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

Hospital & facility affiliations 4

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": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1033767587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST RM 335",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323726",
            "telephone_number": "972-978-6478",
            "fax_number": "212-305-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST RM 335",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323726",
            "telephone_number": "972-978-6478",
            "fax_number": "212-305-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATULIS",
        "first_name": "KRISTEN",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "DNP,  APRN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11003829",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104216100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.