Active NPI
Harshil Matta, DO
- Sports Medicine (Family Medicine) Physician
- Berwyn, IL
National Provider Identifier
1205396124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 319185
- Practice address
- 3231 Euclid Ave FL 5
Berwyn, IL 60402-4603 - Phone
- (708) 783-2000
- NPI assigned
- Mar 25, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125.074250 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 319185 | NY | Primary |
Addresses
Primary practice location
3231 Euclid Ave FL 5
Berwyn, IL 60402-4603
Mailing address
3249 Oak Park Ave
Berwyn, IL 60402-3429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Sports Medicine
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Ptsma Inc
Practice addresses (Care Compare)
111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700
222 Post Rd
Fairfield, CT 06824-6245
Phone (203) 255-8888
324 E 23Rd St
New York, NY 10010-4701
Phone (212) 589-6000
97 Amity St
Brooklyn, NY 11201-6004
Phone (212) 598-6784
Hospital & facility affiliations
- NYU Langone Hospitals
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.8 of 100
- Quality
- 91.79
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.18
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.074250 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients |
Locations
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- hmatta592347@nyumc.direct-ci.com
Organizations & group practices 2
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.
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- New York, NY
- NPI 1275632895
-
- General Acute Care Hospital
- Mineola, NY
- NPI 1427616002
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1619341716
-
- General Acute Care Hospital
- New York, NY
- NPI 1669578324
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696291200000",
"number": "1205396124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3249 OAK PARK AVE",
"city": "BERWYN",
"state": "IL",
"postal_code": "604023429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3231 EUCLID AVE FL 5",
"city": "BERWYN",
"state": "IL",
"postal_code": "604024603",
"telephone_number": "708-783-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTA",
"first_name": "HARSHIL",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-25",
"last_updated": "2023-10-03",
"certification_date": "2023-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "125.074250",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "NY",
"license": "319185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berwyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.