Active NPI
Mira Matayeva, M.S.
- Specialist
- Flushing, NY
National Provider Identifier
1306281977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 2323606
- Practice address
- 147-46 75 Ave Apt 3 D
Flushing, NY 11367 - Phone
- (347) 523-3428
- NPI assigned
- May 8, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 2323606 | NY | Primary |
Addresses
Primary practice location
147-46 75 Ave Apt 3 D
Flushing, NY 11367
Mailing address
147-46 75 Ave Apt 3 D
Flushing, NY 11367
Phone (347) 523-3428
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2323606 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367971200000",
"number": "1306281977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147-46 75 AVE APT 3 D",
"city": "FLUSHING",
"state": "NY",
"postal_code": "11367",
"telephone_number": "347-523-3428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147-46 75 AVE APT 3 D",
"city": "FLUSHING",
"state": "NY",
"postal_code": "11367",
"telephone_number": "347-523-3428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATAYEVA",
"first_name": "MIRA",
"name_prefix": "Mrs.",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-08",
"last_updated": "2013-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "2323606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.