Individual provider Active NPI

Beth Marie Matvya

  • Specialist
  • Westbury, NY
National Provider Identifier
1124940184
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
10865505 Issued in NY
Practice address
1400 Old Country Rd Ste C103N
Westbury, NY 11590-5156
Phone
(631) 398-2784
NPI assigned
Jul 29, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 10865505 NY Primary

Addresses

Primary practice location

1400 Old Country Rd Ste C103N
Westbury, NY 11590-5156

Mailing address

119 Maple PL
Port Jefferson, NY 11777-1632
Phone (631) 398-2784

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

NPI Registry JSON

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

{
    "created_epoch": "1785283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1124940184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 MAPLE PL",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771632",
            "telephone_number": "631-398-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 OLD COUNTRY RD STE C103N",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905156",
            "telephone_number": "631-398-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATVYA",
        "first_name": "BETH",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-29",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "10865505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.