Individual provider Active NPI

Matthew Delph, PA

  • Physician Assistant
  • Port Jefferson, NY
National Provider Identifier
1043792492
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone
(631) 474-6000
NPI assigned
Sep 2, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

200 Belle Terre Rd
Port Jefferson, NY 11777-1928

Mailing address

200 Belle Terre Rd
Port Jefferson, NY 11777-1928

Other practice location 1

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (631) 474-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190604001071 NY Practitioner - Physician Assistant 2567795727 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

129 Sunrise Hwy W
Patchogue, NY 11772-1846
Phone (631) 230-5775

1757 Sunrise Hwy
Bay Shore, NY 11706-6014

1850 Sunrise Hwy
Bay Shore, NY 11706-6012
Phone (631) 581-5900

2280 N Ocean Ave
Farmingville, NY 11738-2911
Phone (631) 698-7828

235 Glen Cove Rd
Carle Place, NY 11514-1221
Phone (516) 877-2273

30 Franklin Ave
Franklin Square, NY 11010-2527
Phone (516) 352-0253

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

4410 Sunrise Hwy
Massapequa, NY 11758-5346
Phone (516) 998-1024

47 Route 25a
Rocky Point, NY 11778-8846
Phone (631) 821-5900

4724 Nesconset Hwy
Port Jefferson Station, NY 11776-2580
Phone (631) 474-5900

519 W Jericho Tpke
Smithtown, NY 11787-2619
Phone (631) 360-5900

5600 Sunrise Hwy
Sayville, NY 11782-1017
Phone (631) 563-7828

600 Portion Rd
Ronkonkoma, NY 11779-1867
Phone (631) 471-5900

895 Montauk Hwy
Shirley, NY 11967-2127
Phone (631) 230-5770

996 Middle Country Rd
Selden, NY 11784-2511
Phone (631) 736-5900

999 Old Country Rd
Riverhead, NY 11901-2113
Phone (631) 284-5900

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
022934NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Nov 1, 2020 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Nov 1, 2020 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

Interoperability endpoints

  • Direct secure messaging: matthew.delph.1@2983.direct.athenahealth.com

Organizations & group practices 6

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": "1535846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1043792492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BELLE TERRE RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BELLE TERRE RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771928",
            "telephone_number": "631-474-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Belle Terre Rd",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117771928",
            "country_code": "US",
            "telephone_number": "631-474-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELPH",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-02",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

Verify at the official NPI Registry.