Organization Active NPI

RM NP in Adult Health P C

  • Adult Health Nurse Practitioner
  • Woodside, NY
National Provider Identifier
1548072036
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
RM NP IN ADULT HEALTH P C
Practice address
6535 Queens Blvd Ste 200
Woodside, NY 11377-5769
Phone
(718) 426-4242
NPI assigned
Jan 22, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Rigina Matatova, NPNPI 1043831530
Title
Owner
Phone
(917) 361-9333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X Primary

Addresses

Primary practice location

6535 Queens Blvd Ste 200
Woodside, NY 11377-5769

Mailing address

6535 Queens Blvd Ste 200
Woodside, NY 11377-5769
Phone (718) 426-4242

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250131000721 NY Part B Supplier - Clinic/Group Practice 2567991847 Receives reassigned benefits from 1 practitioner
Practice locations: Woodside, NY

National Provider Directory

National Provider Directory

Locations

6535 Queens Blvd
Ste 200
Woodside, NY 11377
Phone (718) 426-4242

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1737504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1548072036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6535 QUEENS BLVD STE 200",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113775769",
            "telephone_number": "718-426-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 QUEENS BLVD STE 200",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113775769",
            "telephone_number": "718-426-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RM NP IN ADULT HEALTH P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-22",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "MATATOVA",
        "authorized_official_first_name": "RIGINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-361-9333",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.