Anthony Matrisotto, MAT, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2021025085 Issued in MO

Practice address

12110 Clayton Rd
Saint Louis, MO 63131-2599

Phone

(314) 989-8100

NPI assigned

Jul 7, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1033780481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312599",
            "telephone_number": "314-989-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312599",
            "telephone_number": "314-989-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Hornet Dr",
            "address_purpose": "LOCATION",
            "city": "Hazelwood",
            "state": "MO",
            "postal_code": "630422310",
            "country_code": "US",
            "telephone_number": "314-989-7874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATRISOTTO",
        "first_name": "ANTHONY",
        "credential": "MAT, BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2021025085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Kelly Matlock, MD
• Robert Young Matlock, CRNA
• Sheryl Ladonna Matlock
• Yvonne Marie Matlock
• Deborah Matlof
• Matrix Psychiatric Home Care
• Dzmitry Matsiukevich, MD
• Sarah Christine Matson, PA
• Jun Yamanokuchi Matsui, MD
• Sara Elizabeth Matsumoto, MD

• Behavior Analyst in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.