Active NPI
Robert Emil Matefy, PH.D.
- Clinical Psychologist
- Bridgeport, CT
National Provider Identifier
1225173131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 442
- Practice address
- 2157 North Ave
Bridgeport, CT 06604 - Phone
- (203) 335-0345
- NPI assigned
- Feb 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 442 | CT | Primary |
Addresses
Primary practice location
2157 North Ave
Bridgeport, CT 06604
Mailing address
2157 North Ave
Bridgeport, CT 06604
Phone (203) 335-0345
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4007662 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1970
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2157 N Ave
Bridgeport, CT 06604-2438
Phone (203) 335-0345
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological Associates LLC | Clinical | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244419200000",
"number": "1225173131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2157 NORTH AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "06604",
"telephone_number": "203-335-0345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2157 NORTH AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "06604",
"telephone_number": "203-335-0345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATEFY",
"first_name": "ROBERT",
"middle_name": "EMIL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2009-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "442",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4007662",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; 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.