Giselle Matos

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P104762 Issued in NY

Practice address

315 Wyckoff Ave
Brooklyn, NY 11237-5384

Phone

(718) 497-6090

NPI assigned

Mar 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Interborough Developmental and Consultation Center, Inc.

  • Case Management Agency
  • Brooklyn, NY
  • NPI 1588611842
  Medicare reassignment NPD
• Interborough Developmental and Consultation Center, Inc.

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1912867433
  NPD

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1104451251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 WYCKOFF AVE STE 6",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112375842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 WYCKOFF AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112375384",
            "telephone_number": "718-497-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS",
        "first_name": "GISELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P104762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jubin Eghbali Matloubieh, MD
• Elizabeth Mato, DDS
• Adenela A Matos, M.D
• Ercilia Matos
• Erick Matos
• Jahnyce Matos
• Jose Matos
• Yuleysi Matos
• Rachel Luternauer Matoto, PSY.D.
• George Scott Matous, LCSW

• Mental Health Counselor in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.