Individual provider Active NPI

Megan Matiasek, PNP-C

  • Pediatric Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1427339803
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN267846 Issued in MA
Practice address
225 East Chicago Ave
Box 22
Chicago, IL 60611-5724
Phone
(312) 227-4240
NPI assigned
Aug 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN267846 MA Primary

Addresses

Primary practice location

225 East Chicago Ave
Box 22
Chicago, IL 60611-5724

Mailing address

1817 North Marshfield Ave
Basement Apartment
Chicago, IL 60622-2994
Phone (617) 549-1822

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN267846MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lurie Children'S Medical Group Inc Past Accepting new patients
Lurie Children'S Medical Group, LLC Past Accepting new patients

Organizations & group practices 2

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": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1427339803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 NORTH MARSHFIELD AVE",
            "address_2": "BASEMENT APARTMENT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222994",
            "telephone_number": "617-549-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 EAST CHICAGO AVE",
            "address_2": "BOX 22",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115724",
            "telephone_number": "312-227-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIASEK",
        "first_name": "MEGAN",
        "credential": "PNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN267846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.