King Hamazongo Matulula, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP023478 Issued in PA

Practice address

455 E Bruceton Rd
Pleasant Hills, PA 15236-4538

Phone

(412) 653-9515

Fax

(412) 653-9520

NPI assigned

Feb 4, 2022

Last updated

Feb 4, 2022By the provider in NPPES

Sex

Male

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 PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Waynesburg PA Opco LLC

  dba Waynesburg Nursing and Rehab

  • Skilled Nursing Facility
  • Waynesburg, PA
  • NPI 1174376396

  Adp of the SNF

  CMS ownership

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.

• Sanjay Bharti MD PLLC

  • Internal Medicine Physician
  • Fairmont, WV
  • NPI 1962532549

  PA

  Medicare reassignment NPD
• Fort Pitt Physicians, LLC

  • Family Medicine Physician
  • Pittsburgh, PA
  • NPI 1013664630
  NPD
• Jefferson Hills Operating LLC

  dba Jefferson Hills Healthcare and Rehabilitation Center

  • Skilled Nursing Facility
  • Clairton, PA
  • NPI 1790423994
  NPD (past)

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1346994837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 HI TOR DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152364203",
            "telephone_number": "412-260-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 E BRUCETON RD",
            "city": "PLEASANT HILLS",
            "state": "PA",
            "postal_code": "152364538",
            "telephone_number": "412-653-9515",
            "fax_number": "412-653-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATULULA",
        "first_name": "KING",
        "middle_name": "HAMAZONGO",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP023478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Marie Kelly
• Saralynn Kramm, LPC
• Catherine Lippert
• Anna-Corinne Lobas, RPH
• Angela Marie Logan, PA-C
• Elise Christina Maw, LSW
• Medexpress Urgent Care, LLC - Pleasant Hills
• Medexpress Urgent Care, PC - Pennsylvania (MedExpress Urgent Care - Pleasant Hills)
• Orthopedic and Sports Physical Therapy Associates Inc
• Stephanie Magda Pasquarelli, MSW, LCSW

• Family Nurse Practitioner in Pleasant Hills, PA
• Providers in Pleasant Hills, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.