Individual provider Active NPI

Tumpa Matubber

  • Registered Nurse
  • Copiague, NY
National Provider Identifier
1104788777
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
859579-01 Issued in NY
Practice address
348 Ferraris St
Copiague, NY 11726-1610
Phone
(516) 914-8866
NPI assigned
Dec 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 859579-01 NY Primary

Addresses

Primary practice location

348 Ferraris St
Copiague, NY 11726-1610

Mailing address

348 Ferraris St
Copiague, NY 11726-1610
Phone (516) 914-8866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
859579-01NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1104788777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 FERRARIS ST",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117261610",
            "telephone_number": "516-914-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 FERRARIS ST",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117261610",
            "telephone_number": "516-914-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUBBER",
        "first_name": "TUMPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "859579-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Copiague, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.