Joanna Rose Dematteo Kopf, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

429547-1 Issued in NY

Practice address

12 Cannon Dr
Holbrook, NY 11741-5202

Phone

(631) 256-6493

Fax

(631) 256-6493

NPI assigned

May 20, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1265699839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CANNON DR",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117415202",
            "telephone_number": "631-256-6493",
            "fax_number": "631-256-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 CANNON DR",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117415202",
            "telephone_number": "631-256-6493",
            "fax_number": "631-256-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMATTEO KOPF",
        "first_name": "JOANNA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "429547-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01261816",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Delucia
• Andrea N Delvalle, LPN
• Ashley Delvalle
• Carly M Delvalle, LPN
• Michelle J Delvalle, LPN
• Victoria Dennis
• Jaime Desantis
• Gina Marie Desilva, MS
• Anthony Michael Desivo, PHARMD
• Angela K Desposito, LMSW MHA

• Home Health Registered Nurse in Holbrook, NY
• Providers in Holbrook, NY by specialty
• Home Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.