Individual provider Active NPI

Matthew Fellner, LAC

  • Acupuncturist
  • Jersey City, NJ
National Provider Identifier
1205099793
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
25MZ00051400 Issued in NJ
Practice address
190 Christopher Columbus Dr Ste 3a
Jersey City, NJ 07302-3432
Phone
(201) 724-3998
NPI assigned
Jul 7, 2008
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 25MZ00051400 NJ Primary

Addresses

Primary practice location

190 Christopher Columbus Dr Ste 3a
Jersey City, NJ 07302-3432

Mailing address

107 Hawthorne Ave Apt E
Park Ridge, NJ 07656-3205
Phone (201) 694-1353

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MZ00051400NJMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1205099793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 HAWTHORNE AVE APT E",
            "city": "PARK RIDGE",
            "state": "NJ",
            "postal_code": "076563205",
            "telephone_number": "201-694-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CHRISTOPHER COLUMBUS DR STE 3A",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023432",
            "telephone_number": "201-724-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLNER",
        "first_name": "MATTHEW",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00051400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.