Individual provider Active NPI

Ericka Mae Matzen, FNP

  • Family Nurse Practitioner
  • Troy, NY
National Provider Identifier
1083141295
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
341561 Issued in NY
Practice address
1401 Massachusetts Ave
Troy, NY 12180-1621
Phone
(518) 268-6265
NPI assigned
May 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 341561 NY Primary

Addresses

Primary practice location

1401 Massachusetts Ave
Troy, NY 12180-1621

Mailing address

109 Rensselaer Ave
Cohoes, NY 12047-3520
Phone (518) 817-5274

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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
I20170726000477 NY Practitioner - Nurse Practitioner 0749550622 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York CurrentSince Jan 1, 2019 Accepting new patients

Locations

713 Troy Schenectady Rd
Ste 304
Latham, NY 12110
Phone (518) 373-4448

2231 Burdett Ave
Ste 110
Troy, NY 12180
Phone (518) 271-3900

1401 Massachusetts Ave
Troy, NY 12180
Phone (518) 268-5242

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Interoperability endpoints

  • Direct secure messaging: ematzen834633@direct.trinity-health.org

Organizations & group practices 1

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": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1083141295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 RENSSELAER AVE",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "120473520",
            "telephone_number": "518-817-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MASSACHUSETTS AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121801621",
            "telephone_number": "518-268-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZEN",
        "first_name": "ERICKA",
        "middle_name": "MAE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPH Payer Credentialing@sphp.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1401 Massachusetts Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121801621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.