NPIMap

Individual provider Active NPI

Andrea Marie Matteliano, PA-C

  • Physician Assistant
  • Amherst, NY
National Provider Identifier
1134544604
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
23 017438 Issued in NY
Practice address
3980 Sheridan Dr
Amherst, NY 14226-1727
Phone
(716) 250-2000
Fax
(716) 250-2040
NPI assigned
Feb 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 23 017438 NY Primary

Addresses

Primary practice location

3980 Sheridan Dr
Amherst, NY 14226-1727

Mailing address

3980 Sheridan Dr
Amherst, NY 14226-1727
Phone (716) 250-2000

Other practice location 1

1751 Sheridan Dr
Tonawanda, NY 14223
Phone (716) 844-7100

Other identifiers 2

IdentifierTypeStateIssuer
017438OtherNYPA LICENSE
23 017438OtherNYNYS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140620000113 NY Practitioner - Physician Assistant 6002030707 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Niagara Neurology PCGroup PAC ID 8628294618, 5 clinicians

Practice addresses (Care Compare)

77 Elizabeth Dr
Lockport, NY 14094-5226
Phone (716) 566-9900

Hospital & facility affiliations

  • Mount St. Mary'S Hospital & Health Center Hospital, Lewiston, NY, CCN 330188
  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Niagara Falls Memorial Medical Center Hospital, Niagara Falls, NY, CCN 330065
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005
  • Kenmore Mercy Hospital Hospital, Kenmore, NY, CCN 330102

Merit-based Incentive Payment System (MIPS)

Final score
44.01 of 100Reported as group
Promoting interoperability
0
Improvement activities
40
Cost
80.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
23 017438NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ub Family Medicine, Inc Current Accepting new patients

Locations

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

Organizations & group practices 4

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1134544604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3980 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261727",
            "telephone_number": "716-250-2000",
            "fax_number": "716-250-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261727",
            "telephone_number": "716-250-2000",
            "fax_number": "716-250-2040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1751 Sheridan Dr",
            "address_purpose": "LOCATION",
            "city": "Tonawanda",
            "state": "NY",
            "postal_code": "14223",
            "country_code": "US",
            "telephone_number": "716-844-7100",
            "fax_number": "716-564-1134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTELIANO",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-20",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "23 017438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "017438",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS",
            "identifier": "23 017438",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.