Nicole Lynn Matuska

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R176455 Issued in MD

Practice address

4924 Campbell Blvd
Nottingham, MD 21236-5908

Phone

(443) 442-2300

NPI assigned

Jun 19, 2013

Last updated

Oct 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1255359972
  NPD

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1174962468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 BIMINI DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210151796",
            "telephone_number": "410-459-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4924 CAMPBELL BLVD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212365908",
            "telephone_number": "443-442-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5230 Campbell Blvd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212364983",
            "country_code": "US",
            "telephone_number": "410-933-9632",
            "fax_number": "410-933-0190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9901 York Rd",
            "address_purpose": "LOCATION",
            "city": "Cockeysville",
            "state": "MD",
            "postal_code": "210303407",
            "country_code": "US",
            "telephone_number": "410-683-6517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATUSKA",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R176455",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R176455",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasmim Matheus Phipps
• Alyssa Mary Mathew, D.O
• Bob Mathews, D.D.S.
• Rita Mathur, MD
• Iesha N Matthews
• Laura Ann Maurin, PHARM.D.
• Aaron McCauley
• Nathan Dixon McClain
• McClary Counseling, LLC
• Allan Bruce McClary, LCSW, CCM

• Family Nurse Practitioner in Nottingham, MD
• Providers in Nottingham, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.