Individual provider Active NPI

Matthew John Buttigieg, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1548714769
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F402038-1 Issued in NY
Practice address
117 W 72ND St FL 3
New York, NY 10023-3204
Phone
(212) 799-7777
Fax
(646) 799-7772
NPI assigned
Aug 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ15033500 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F402038-1 NY Primary

Addresses

Primary practice location

117 W 72ND St FL 3
New York, NY 10023-3204

Mailing address

117 W 72ND St FL 3
New York, NY 10023-3204
Phone (212) 799-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 22, 2018 through Jan 22, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
402038NYMDRegistered Nurse
26NJ15033500NJMDPsychiatric/Mental Health Nurse Practitioner
F402038-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clearly NP in Psychiatry, PLLC Psychiatric/Mental Health Current Accepting new patients
Dulchin & Fader, Inc Past Accepting new patients
Richard Nathanson, M.D., PLLC Past Accepting new patients

Locations

117 W 72nd St
Fl 3
New York, NY 10023
Phone (212) 777-7779

Organizations & group practices 3

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": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1548714769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W 72ND ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100233204",
            "telephone_number": "212-799-7777",
            "fax_number": "212-799-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W 72ND ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100233204",
            "telephone_number": "212-799-7777",
            "fax_number": "646-799-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTIGIEG",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-04",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15033500",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402038-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.