Individual provider Active NPI

Matthew Demattia, MS, CCC-SLP

  • Speech-Language Pathologist
  • West Babylon, NY
National Provider Identifier
1376169201
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
023643-01 Issued in NY
Practice address
1436 13TH St
West Babylon, NY 11704-3224
Phone
(631) 422-0869
NPI assigned
Jun 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 023643-01 NY Primary

Addresses

Primary practice location

1436 13TH St
West Babylon, NY 11704-3224

Mailing address

1436 13TH St
West Babylon, NY 11704-3224
Phone (631) 905-9983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200720002076 NY Practitioner - Qualified Speech Language Pathologist 5294159588 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

800 E Gate Blvd
Garden City, NY 11530-2105
Phone (516) 745-8070

Merit-based Incentive Payment System (MIPS)

Final score
77.35 of 100Reported as group
Quality
73.31
Improvement activities
40
Cost
73.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
023643-01NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Li Professional Speech PLLC Speech-Language Pathologist CurrentSince Sep 4, 2024 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Speech-Language Pathologist CurrentSince Aug 7, 2020 Accepting new patients
Ats Rehab OT & PT & SLP PLLC Speech-Language Pathologist CurrentSince May 1, 2020 Accepting new patients
Metro PT OT and SLP Health PLLC CurrentSince Mar 6, 2024 Accepting new patients
Ny Speech Pathology Consultants, P.C. Speech-Language Pathologist CurrentSince Aug 11, 2020 Accepting new patients

Locations

1105 E County Line Rd
Ste 213
Lakewood, NJ 08701

4080 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 738-4844

10825 Horace Harding Expy
Flushing, NY 11368
Phone (516) 216-4108

800 E Gate Blvd
Garden City, NY 11530

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

274 W Broadway
Long Beach, NY 11561
Phone (516) 431-1400

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

Organizations & group practices 6

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": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1376169201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 13TH ST",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117043224",
            "telephone_number": "631-905-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 13TH ST",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117043224",
            "telephone_number": "631-422-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMATTIA",
        "first_name": "MATTHEW",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "023643-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.