Active NPI
Lev Y Matatov, CFO,BOCO,COTA
- Orthotist
- Fresh Meadows, NY
National Provider Identifier
1295999399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- Practice address
- 7721 166TH St
Fresh Meadows, NY 11366-1232 - Phone
- (646) 267-2409
- Fax
- (516) 213-2732
- NPI assigned
- Jul 17, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | |||
| Orthotist | 222Z00000X | NY | Primary | |
| Occupational Therapy Assistant | 224Z00000X | 004659 | NY |
Addresses
Primary practice location
7721 166TH St
Fresh Meadows, NY 11366-1232
Mailing address
7721 166TH St
Fresh Meadows, NY 11366-1232
Phone (646) 267-2409
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02864 | Other | NY | AMERICAN BOARD CERTIFIED FITTER- ORTHOTICS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004659 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehab1One Op LTD | Orthotist | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255392000000",
"number": "1295999399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7721 166TH ST",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113661232",
"telephone_number": "646-267-2409",
"fax_number": "516-213-2732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7721 166TH ST",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113661232",
"telephone_number": "646-267-2409",
"fax_number": "516-213-2732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATATOV",
"first_name": "LEV",
"middle_name": "Y",
"credential": "CFO,BOCO,COTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-17",
"last_updated": "2009-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "NY",
"license": null,
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "004659",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN BOARD CERTIFIED FITTER- ORTHOTICS",
"identifier": "02864",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresh Meadows, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.