Alyssa Rae Matuszak, CPNP-AC

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

5928-33 Issued in WI

Practice address

9000 W. Wisconsin Ave
Ms 681
Milwaukee, WI 53226

Phone

(414) 266-3360

Fax

(414) 266-3563

NPI assigned

Aug 15, 2014

Last updated

Oct 2, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Alyssa Rae Doughty Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Childrens Specialty Group IncGroup PAC ID 2567813447, 206 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adoughty21699@direct.chw.org

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.

• Children's Specialty Group, Inc.

  • Pediatrics Physician
  • Milwaukee, WI
  • NPI 1942970405
  Medicare reassignment Care Compare group NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment NPD

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1093114050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W. WISCONSIN AVE",
            "address_2": "MS 681",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-266-3360",
            "fax_number": "414-266-3563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W. WISCONSIN AVE",
            "address_2": "MS 681",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-266-3360",
            "fax_number": "414-266-3563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUSZAK",
        "first_name": "ALYSSA",
        "middle_name": "RAE",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "WI",
            "license": "5928-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "179985",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093114050",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "DOUGHTY",
            "middle_name": "RAE",
            "credential": "CPNP-AC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Rose Mattoon, MD
• Britney Mattox
• Lakendra Mynetta Mattox
• Kienna Matus
• Itzhak Matusiak, PH.D
• Michael Edward Matye, DNP
• Michael J Matysik, DPT
• Cory J. Matz, M.D.
• Katherine Therese Matz
• Kelly Lynn Matz

• Critical Care Pediatric Nurse Practitioner in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Critical Care Pediatric Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.