Kathilee J Matamoros

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP012283 Issued in PA

Practice address

6820 NW 23Rd St
Bethany, OK 73008-5217

Phone

(405) 495-5154

NPI assigned

Jun 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Kathilee J Davidson Former name

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Claremore Health Associates, IncGroup PAC ID 0840214904, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hillcrest Hospital Claremore Hospital, Claremore, OK, CCN 370039
• Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
• Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Claremore Health Associates Inc

  • Family Medicine Physician
  • Claremore, OK
  • NPI 1982722195
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Claremore Regional Hospital, LLC.

  • General Acute Care Hospital
  • Claremore, OK
  • NPI 1023398807
  Care Compare affiliation
• Ahs Hillcrest Medical Center, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1003039488
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  Care Compare affiliation

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1508128158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6820 NW 23RD ST",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730085217",
            "telephone_number": "405-495-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 NW 23RD ST",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730085217",
            "telephone_number": "405-495-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAMOROS",
        "first_name": "KATHILEE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "TLRN039071",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP012283",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP012283",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "90694",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200526530A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHILEE",
            "last_name": "DAVIDSON",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erin March, M.ED.,CCC-SLP
• Mark B. Privott, O.D., Inc
• Mark Shreffler LPC LLC
• Rosa Maria Martinez Deloera, RD/LD
• Michael J. Massoni, B.S., C.C.P., L.P
• David Mathew, APRN
• Cami Matthews, PT
• Melissa K McCarty, PA-C
• Wade T McCoy, MD
• Erin M McGowen

• Family Nurse Practitioner in Bethany, OK
• Providers in Bethany, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.