Rushdan Muhammad Mateen

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

345A Greenwood St
Worcester, MA 01607-1753

Phone

(508) 363-0200

Fax

(508) 363-1213

NPI assigned

Jul 23, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ahman Ali Graham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Behavioral Concepts Innovation, LLC

  • Community/Behavioral Health Agency
  • Worcester, MA
  • NPI 1548544026
  NPD (past)

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1124671730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345A GREENWOOD ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016071753",
            "telephone_number": "508-363-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345A GREENWOOD ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016071753",
            "telephone_number": "508-363-0200",
            "fax_number": "508-363-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEEN",
        "first_name": "RUSHDAN",
        "middle_name": "MUHAMMAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AHMAN",
            "last_name": "GRAHAM",
            "middle_name": "ALI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lynne A. Masterson, CNM
• Kelly Masula, NP
• Arline Mata
• Bwema Matata
• Joel J Match, PH.D.
• Yalisbeth Mateo
• Alexandra Maters
• Theofilos P. Matheos, MD
• Jolie Kim Brenhofer Matheson, M.S.
• Malcolm Alexander Matheson

• Developmental Therapist in Worcester, MA
• Providers in Worcester, MA by specialty
• Developmental Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.