Individual provider Active NPI

Katharine M Matthis, RPA-C

  • Physician Assistant
  • Saint Regis Falls, NY
National Provider Identifier
1073697694
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006534 Issued in NY
Practice address
76 North Main Street
Saint Regis Falls, NY 12980
Phone
(518) 481-8460
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 006534 NY
Family Medicine Physician 207Q00000X 006534-1 NY
Medical Physician Assistant 363AM0700X 006534 NY
Physician Assistant 363A00000X 006534 NY Primary

Addresses

Primary practice location

76 North Main Street
Saint Regis Falls, NY 12980

Mailing address

214 King St
Ogdensburg, NY 13669-1142
Phone (315) 393-3600

Other practice location 1

39 W Main St
Canton, NY 13617-1358
Phone (315) 379-4700

Other identifiers 1

IdentifierTypeStateIssuer
01895252MedicaidNY

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
I20040108001018 NY Practitioner - Physician Assistant 6204736101 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alice Hyde Medical CenterGroup PAC ID 4082525837, 88 clinicians

Practice addresses (Care Compare)

133 Park St
Malone, NY 12953-1243

133 Park St
Malone, NY 12953-1244

134 Park St
Malone, NY 12953-1251
Phone (518) 481-2800

16 3Rd St a
Malone, NY 12953-1305
Phone (518) 481-2870

16 3Rd St B
Malone, NY 12953-1305
Phone (518) 481-2870

16 4TH St C
Malone, NY 12953-1340
Phone (518) 481-2896

183 Park St
Malone, NY 12953-1238

187 Park St
Suite 2
Malone, NY 12953-1233
Phone (518) 481-2790

20 4TH St
Suite 2
Malone, NY 12953-1339
Phone (518) 481-2677

23 4TH St
Malone, NY 12953-1331
Phone (518) 481-2880

23 Forth St
Suite 1
Malone, NY 12953-1238
Phone (518) 481-8080

24 4TH St
Suite 4
Malone, NY 12953-1350
Phone (518) 481-2632

45 6TH St
Malone, NY 12953-1246
Phone (518) 481-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006534-1NYMDFamily Medicine Physician
006534NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Hyde Medical Center Family Medicine CurrentSince May 16, 2025 Accepting new patients
Alice Hyde Medical Center PastSince Jun 3, 2025 Accepting new patients

Locations

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

Interoperability endpoints

  • Direct secure messaging: kmatthis616624@direct.uvmhealth.org

Organizations & group practices 4

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1073697694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 KING ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691142",
            "telephone_number": "315-393-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 NORTH MAIN STREET",
            "city": "SAINT REGIS FALLS",
            "state": "NY",
            "postal_code": "12980",
            "telephone_number": "518-481-8460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39 W Main St",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "NY",
            "postal_code": "136171358",
            "country_code": "US",
            "telephone_number": "315-379-4700",
            "fax_number": "315-713-6512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTHIS",
        "first_name": "KATHARINE",
        "middle_name": "M",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "006534",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "006534-1",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "006534",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01895252",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Regis Falls, NY

Sources for this page

Verify at the official NPI Registry.