NPIMap

Individual provider Active NPI

Victoria Matkowski, CCC-SLP

  • Speech-Language Pathologist
  • Fairfax, VA
National Provider Identifier
1114262102
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202006424 Issued in VA
Practice address
11150 Fairfax Blvd
Suite 500
Fairfax, VA 22030-5066
Phone
(703) 537-0373
Fax
(703) 865-7379
NPI assigned
Dec 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202006424 VA Primary

Addresses

Primary practice location

11150 Fairfax Blvd
Suite 500
Fairfax, VA 22030-5066

Mailing address

11150 Fairfax Blvd
Suite 500
Fairfax, VA 22030-5066
Phone (703) 537-0373

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
2202006424VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Speech-Language Pathology Group PLLC Speech-Language Pathologist Past Accepting new patients
Elliot R Goldstein MD & Joel R Schulman MD PA Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1114262102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11150 FAIRFAX BLVD",
            "address_2": "SUITE 500",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305066",
            "telephone_number": "703-537-0373",
            "fax_number": "703-865-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 FAIRFAX BLVD",
            "address_2": "SUITE 500",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305066",
            "telephone_number": "703-537-0373",
            "fax_number": "703-865-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATKOWSKI",
        "first_name": "VICTORIA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.