Individual provider Active NPI

Paul Joseph Matty, MD

  • Internal Medicine Physician
  • Dayville, CT
National Provider Identifier
1255493698
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
029500 Issued in CT
Practice address
612 Hartford Pike
Dayville, CT 06241
Phone
(860) 779-0867
Fax
(860) 779-0386
NPI assigned
Dec 14, 2006
Last updated
Nov 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 029500 CT Primary

Addresses

Primary practice location

612 Hartford Pike
Dayville, CT 06241

Mailing address

612 Hartford Pike
Dayville, CT 06241
Phone (860) 779-0867

Other identifiers 1

IdentifierTypeStateIssuer
001295006MedicaidCT

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070420000082 CT Practitioner - Internal Medicine 8325143340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Day Kimball Medical Group IncGroup PAC ID 1557514411, 91 clinicians

Practice addresses (Care Compare)

132 Westminster Rd
Family Medicine Canterbury
Canterbury, CT 06331-1454
Phone (860) 546-2225

320 Pomfret St
Putnam, CT 06260-1836
Phone (860) 928-6541

612 Hartford Pike
Dayville, CT 06241-2159
Phone (860) 779-0867

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029500CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Day Kimball Medical Group Inc Internal Medicine CurrentSince Jan 1, 2013 Accepting new patients

Locations

132 Westminster Rd
Canterbury, CT 06331
Phone (860) 546-2225

45 Green Hollow Rd
Danielson, CT 06239
Phone (860) 774-1255

612 Hartford Pike
Dayville, CT 06241
Phone (860) 779-0284

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

320 Pomfret St
#2
Putnam, CT 06260

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1694/brand/19/csg/48/fhir/r4
  • Direct secure messaging: paul.matty.1@1694.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1255493698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 HARTFORD PIKE",
            "city": "DAYVILLE",
            "state": "CT",
            "postal_code": "06241",
            "telephone_number": "860-779-0867",
            "fax_number": "860-779-0386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 HARTFORD PIKE",
            "city": "DAYVILLE",
            "state": "CT",
            "postal_code": "06241",
            "telephone_number": "860-779-0867",
            "fax_number": "860-779-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTY",
        "first_name": "PAUL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "029500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001295006",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayville, CT

Sources for this page

Verify at the official NPI Registry.