Individual provider Active NPI

Andrew P Matassa, D.C.

  • Chiropractor
  • Long Island City, NY
National Provider Identifier
1376612937
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X007817-1 Issued in NY
Practice address
2120 33Rd Rd
Suite 1a
Long Island City, NY 11106-4286
Phone
(718) 726-0328
Fax
(718) 726-0419
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X007817-1 NY Primary
Chiropractor 111N00000X 38MC00653300 NJ

Addresses

Primary practice location

2120 33Rd Rd
Suite 1a
Long Island City, NY 11106-4286

Mailing address

2120 33Rd Rd
Suite 1a
Long Island City, NY 11106-3411
Phone (718) 726-0328

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111216000173 NY Practitioner - Chiropractic 2860598968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1994
Medicare assignment
May accept Medicare assignment
Group practices
Family Chiropractors PCGroup PAC ID 9133394380, 2 clinicians

Practice addresses (Care Compare)

2120 33Rd Rd
Apt 1a
Astoria, NY 11106-4247
Phone (718) 726-0328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00653300NJMDChiropractor
X007817-1NYMDChiropractor

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1376612937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 33RD RD",
            "address_2": "SUITE 1A",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111063411",
            "telephone_number": "718-726-0328",
            "fax_number": "718-726-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 33RD RD",
            "address_2": "SUITE 1A",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111064286",
            "telephone_number": "718-726-0328",
            "fax_number": "718-726-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATASSA",
        "first_name": "ANDREW",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007817-1",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00653300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.