Individual provider Active NPI

Alrina Manatad Matienzo

  • Registered Nurse
  • Thornton, CO
National Provider Identifier
1053900217
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1666071 Issued in CO
Practice address
3450 E 123Rd Dr
Thornton, CO 80241-2852
Phone
(720) 779-6550
NPI assigned
Jan 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1666071 CO Primary

Addresses

Primary practice location

3450 E 123Rd Dr
Thornton, CO 80241-2852

Mailing address

3450 E 123Rd Dr
Thornton, CO 80241-2852
Phone (720) 779-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1666071COMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1053900217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 E 123RD DR",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802412852",
            "telephone_number": "720-779-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 E 123RD DR",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802412852",
            "telephone_number": "720-779-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIENZO",
        "first_name": "ALRINA",
        "middle_name": "MANATAD",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "1666071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.