Individual provider Active NPI

Debra Lee Matt, FNP-C

  • Family Nurse Practitioner
  • Cazenovia, NY
National Provider Identifier
1093252629
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F339775-1 Issued in NY
Practice address
4400 Francis Rd
Cazenovia, NY 13035-8471
Phone
(315) 256-8109
NPI assigned
Jan 20, 2017
Last updated
Jan 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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 F339775-1 NY Primary

Addresses

Primary practice location

4400 Francis Rd
Cazenovia, NY 13035-8471

Mailing address

4400 Francis Rd
Cazenovia, NY 13035-8471
Phone (315) 256-8109

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
I20180220002239 NY Practitioner - Nurse Practitioner 6709147408 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F339775-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Jan 29, 2018 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jan 29, 2018 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Feb 1, 2023 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

6870 E Genesee St
Fayetteville, NY 13066
Phone (315) 679-4367

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

20 Chapel St
Sherburne, NY 13460
Phone (607) 674-2445

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1093252629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 FRANCIS RD",
            "city": "CAZENOVIA",
            "state": "NY",
            "postal_code": "130358471",
            "telephone_number": "315-256-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 FRANCIS RD",
            "city": "CAZENOVIA",
            "state": "NY",
            "postal_code": "130358471",
            "telephone_number": "315-256-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATT",
        "first_name": "DEBRA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339775-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cazenovia, NY

Sources for this page

Verify at the official NPI Registry.