Individual provider Active NPI

Julian Matra

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1225595648
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P132759 Issued in NY
Practice address
906 E New York Ave Apt 3B
Brooklyn, NY 11203-5057
Phone
(617) 407-1473
NPI assigned
Feb 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P132759 NY Primary
Behavior Analyst 103K00000X

Addresses

Primary practice location

906 E New York Ave Apt 3B
Brooklyn, NY 11203-5057

Mailing address

906 E New York Ave Apt 3B
Brooklyn, NY 11203-5057

Other practice location 1

144 Washington St # 2
Brighton, MA 02135-4324
Phone (617) 407-1473

Other practice location 2

144 Washington St # 2
Brighton, MA 02135-4324
Phone (617) 407-1473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P132759NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1225595648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 E NEW YORK AVE APT 3B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 E NEW YORK AVE APT 3B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035057",
            "telephone_number": "617-407-1473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "144 Washington St # 2",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021354324",
            "country_code": "US",
            "telephone_number": "617-407-1473",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "144 Washington St # 2",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021354324",
            "country_code": "US",
            "telephone_number": "617-407-1473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATRA",
        "first_name": "JULIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-21",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "P132759",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.