Individual provider Active NPI

Jamie Lynn Matteo, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Warren, OH
National Provider Identifier
1093075020
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
003719 Issued in OH
Practice address
628 Niles Cortland Rd SE Ste 103
Warren, OH 44484-2473
Phone
(330) 372-2218
Fax
(330) 372-2572
NPI assigned
May 24, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 003719 OH Primary

Addresses

Primary practice location

628 Niles Cortland Rd SE Ste 103
Warren, OH 44484-2473

Mailing address

628 Niles Cortland Rd SE Ste 103
Warren, OH 44484-2473
Phone (330) 372-2218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150729007171 OH Practitioner - Podiatry 2860706322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jamie L Matteo DPM IncGroup PAC ID 1951615418, 2 clinicians

Practice addresses (Care Compare)

628 Niles Cortland Rd SE
Suite 103
Warren, OH 44484-2473
Phone (330) 372-2218

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue79
Removal of skin lesions1-10
Removal of nail tissue252
Removal or shaving of skin growth24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003719OHMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jamie L Matteo DPM, Inc Foot & Ankle Surgery CurrentSince Jul 1, 2015 Accepting new patients

Locations

2900 Elm Rd NE
Warren, OH 44483
Phone (330) 372-1236

628 Niles Cortland Rd SE
Ste 103
Warren, OH 44484
Phone (330) 372-2218

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093075020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 NILES CORTLAND RD SE STE 103",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842473",
            "telephone_number": "330-372-2218",
            "fax_number": "330-372-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 NILES CORTLAND RD SE STE 103",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842473",
            "telephone_number": "330-372-2218",
            "fax_number": "330-372-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTEO",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "003719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.