Individual provider Active NPI

Clare Louise Matis, FNP-BC

  • Family Nurse Practitioner
  • Newark, DE
National Provider Identifier
1043659386
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG000651 Issued in DE
Practice address
324 E Main St
Suite 202
Newark, DE 19711-7150
Phone
(302) 369-2751
NPI assigned
Jun 20, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG000651 DE Primary

Addresses

Primary practice location

324 E Main St
Suite 202
Newark, DE 19711-7150

Mailing address

324 E Main St
Suite 202
Newark, DE 19711-7150
Phone (302) 369-2751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130812000242 DE Practitioner - Nurse Practitioner 3577705185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delaware Hospice, Inc.Group PAC ID 8921101395, 8 clinicians

Practice addresses (Care Compare)

630 Churchmans Rd
Suite 200
Newark, DE 19702-1944
Phone (302) 478-5707

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LG000651DEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Hospice, Inc CurrentSince Jul 1, 2013 Accepting new patients
Dr. Mark Glassner PastSince Oct 1, 2017 Accepting new patients

Locations

630 Churchmans Rd
Ste 200
Newark, DE 19702
Phone (302) 478-5707

Organizations & group practices 2

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": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1043659386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 E MAIN ST",
            "address_2": "SUITE 202",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197117150",
            "telephone_number": "302-369-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E MAIN ST",
            "address_2": "SUITE 202",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197117150",
            "telephone_number": "302-369-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIS",
        "first_name": "CLARE",
        "middle_name": "LOUISE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG000651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.