Individual provider Active NPI

Matejka Raylyn Abeita

  • Athletic Trainer
  • Milwaukee, WI
National Provider Identifier
1396533907
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
770 N 12TH St
Milwaukee, WI 53233-2203
Phone
(414) 288-6303
NPI assigned
Apr 25, 2025
Sex
Female
Sole proprietor
Yes

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Primary

Addresses

NPPES NPI Registry

Primary practice location

770 N 12TH St
Milwaukee, WI 53233-2203

Mailing address

PO Box 671
Gallup, NM 87305-0671
Phone (505) 870-4501

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 25, 2025.

{
    "created_epoch": "1745539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1396533907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 671",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873050671",
            "telephone_number": "505-870-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332203",
            "telephone_number": "414-288-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABEITA",
        "first_name": "MATEJKA",
        "middle_name": "RAYLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-25",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; 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.