Kristie Matos

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

738069 Issued in NY

Practice address

2778 3Rd Ave
Bronx, NY 10455-4029

Phone

(718) 402-9000

NPI assigned

Mar 5, 2018

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520208000000",
    "number": "1417459546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 DECATUR AVE APT 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104674258",
            "telephone_number": "646-751-9856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2778 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554029",
            "telephone_number": "718-402-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS",
        "first_name": "KRISTIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2018-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "738069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos Manuel Matos, MSED
• Elaine Marie Matos, FNP-BC
• Gypsy Matos
• Jessica Matos, LMSW
• Johanny Matos
• Melanie Matos
• Robersy Matos
• Shamika Leae Matos
• Veronica Matos, LPN
• Yokasta Matos

• Addiction (Substance Use Disorder) Registered Nurse in Bronx, NY
• Providers in Bronx, NY by specialty
• Addiction (Substance Use Disorder) Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; 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.