NPIMap

Individual provider Active NPI

Kristin Ann Matteson, D.O.

  • Nephrology Physician
  • Amherst, NY
National Provider Identifier
1063532125
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
215890 Issued in NY
Practice address
1306 Sweet Home Rd
Amherst, NY 14228-2792
Phone
(716) 838-3188
Fax
(716) 838-1297
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 215890 NY Primary

Addresses

Primary practice location

1306 Sweet Home Rd
Amherst, NY 14228-2792

Mailing address

1306 Sweet Home Rd
Amherst, NY 14228-2792
Phone (716) 838-3188

Other identifiers 1

IdentifierTypeStateIssuer
02422071MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100910000456 NY Practitioner - NephrologyPractitioner - Internal Medicine 8527183888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Associates of Western New York, LLPGroup PAC ID 3476520560, 15 clinicians

Practice addresses (Care Compare)

1306 Sweet Home Rd
Amherst, NY 14228-2792
Phone (716) 838-3188

220 Red Tail Rd
Suite 2
Orchard Park, NY 14127-1599
Phone (716) 712-0864

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
215890NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Western New York, LLP Nephrology CurrentSince Aug 1, 2003 Accepting new patients
Usrc West Cheektowaga, LLC PastSince May 1, 2015 Accepting new patients

Locations

4233 Maple Rd
Buffalo, NY 14226
Phone (716) 631-2728

1306 Sweet Home Rd
Buffalo, NY 14228
Phone (716) 222-0297

220 Red Tail Rd
Ste 2
Orchard Park, NY 14127
Phone (716) 222-0297

Interoperability endpoints

  • Direct secure messaging: kmatteson@nephrologypractice.medentdirect.com

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1063532125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 SWEET HOME RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142282792",
            "telephone_number": "716-838-3188",
            "fax_number": "716-838-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 SWEET HOME RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142282792",
            "telephone_number": "716-838-3188",
            "fax_number": "716-838-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTESON",
        "first_name": "KRISTIN",
        "middle_name": "ANN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "215890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02422071",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.