Individual provider Active NPI

Josh Michael Matecki, PA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1063873339
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019585 Issued in NY
Practice address
206 S Elmwood Ave
Buffalo, NY 14201-2398
Phone
(716) 847-2441
NPI assigned
Mar 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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 019585 NY Primary

Addresses

Primary practice location

206 S Elmwood Ave
Buffalo, NY 14201-2398

Mailing address

206 S Elmwood Ave
Buffalo, NY 14201-2398
Phone (716) 847-2441

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
I20160505000140 NY Practitioner - Physician Assistant 7911206404 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ehs, IncGroup PAC ID 7618946310, 41 clinicians

Practice addresses (Care Compare)

206 S Elmwood Ave
Buffalo, NY 14201-2398
Phone 71684724411716

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ehs, Inc. CurrentSince Aug 1, 2016 Accepting new patients

Locations

206 S Elmwood Ave
Buffalo, NY 14201
Phone (716) 847-0212

Interoperability endpoints

  • Direct secure messaging: jmatecki@evergreenhs.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.

NPI Registry JSON

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1063873339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S ELMWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142012398",
            "telephone_number": "716-847-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S ELMWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142012398",
            "telephone_number": "716-847-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATECKI",
        "first_name": "JOSH",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-15",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.