NPIMap

Individual provider Active NPI

Matthew L. Denno, M.D.

  • Family Medicine Physician
  • New Paltz, NY
National Provider Identifier
1225187743
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
214974 Issued in NY
Practice address
26 North Front Street
New Paltz, NY 12561
Phone
(845) 255-7900
Fax
(845) 255-7901
NPI assigned
Jan 10, 2007
Last updated
Aug 29, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 214974 NY Primary

Addresses

Primary practice location

26 North Front Street
New Paltz, NY 12561

Mailing address

26 North Front Street
New Paltz, NY 12561
Phone (845) 255-7900

Other identifiers 1

IdentifierTypeStateIssuer
02042822MedicaidNY

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
I20051021000144 NY Practitioner - Family Practice 0941226674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
214974NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Dec 15, 2017 Accepting new patients
Optum Medical Care, P.C. CurrentSince Dec 15, 2017 Accepting new patients
Mid-Hudson Family Health Institute Family Medicine Past Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

26 N Front St
New Paltz, NY 12561
Phone (845) 255-7900

264 Main St
New Paltz, NY 12561
Phone (845) 255-7901

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1225187743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 NORTH FRONT STREET",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "12561",
            "telephone_number": "845-255-7900",
            "fax_number": "845-255-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 NORTH FRONT STREET",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "12561",
            "telephone_number": "845-255-7900",
            "fax_number": "845-255-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNO",
        "first_name": "MATTHEW",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "214974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02042822",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Paltz, NY

Sources for this page

Verify at the official NPI Registry.