Annmarie Matusak, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30.020318 Issued in OH

Practice address

3050 Mack Rd
ML 6007
Fairfield, OH 45014

Phone

(513) 636-6400

Fax

(513) 636-6452

NPI assigned

Sep 22, 2006

Last updated

Jan 26, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Children's Hospital Medical Center

  dba Cincinnati Children's Hospital Medical Center

  • Pediatrics Physician
  • Cincinnati, OH
  • NPI 1609915784
  Medicare reassignment NPD

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1265531636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 MACK RD.",
            "address_2": "ML 6007",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "45014",
            "telephone_number": "513-636-6400",
            "fax_number": "513-636-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 MACK RD",
            "address_2": "ML 6007",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "45014",
            "telephone_number": "513-636-6400",
            "fax_number": "513-636-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUSAK",
        "first_name": "ANNMARIE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.020318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Mathews
• Kamilah Mathieu
• Upasana Mathur
• Matrix Rehabilitation Ohio, Inc (Northern Cincinnati Sports Medicine & Physical Therapy)
• Danita Yolanda Matthews
• William J Mauntel, M.D.
• Michael May, CDCA
• Terri May, RPH
• Garrett Mayhugh, AUD
• Luc Mbayabu Lukasu

• Pediatric Dentistry in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Pediatric Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.