Individual provider Active NPI

Robert Matuszek

  • Addiction (Substance Use Disorder) Registered Nurse
  • Providence, RI
National Provider Identifier
1336689637
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
RN33605 Issued in RI
Practice address
66 Pavilion Ave
Providence, RI 02905-1522
Phone
(401) 461-9110
Fax
(401) 461-9194
NPI assigned
Mar 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X RN33605 RI Primary

Addresses

Primary practice location

66 Pavilion Ave
Providence, RI 02905-1522

Mailing address

66 Pavilion Ave
Providence, RI 02905-1522
Phone (401) 461-9110

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

LicenseStateTypeSpecialty
RN33605RIMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1336689637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 PAVILION AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029051522",
            "telephone_number": "401-461-9110",
            "fax_number": "401-461-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 PAVILION AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029051522",
            "telephone_number": "401-461-9110",
            "fax_number": "401-461-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUSZEK",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "RI",
            "license": "RN33605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.