Active NPI
Norman Matthews, P.A.
- Physician Assistant
- Brooklyn, NY
National Provider Identifier
1558762260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 006008-1
- Practice address
- 678 Grand St
Brooklyn, NY 11211-8465 - Phone
- (718) 782-5907
- Fax
- (718) 782-5917
- NPI assigned
- Sep 12, 2014
- Last updated
- Sep 12, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 006008-1 | NY | Primary |
Addresses
Primary practice location
678 Grand St
Brooklyn, NY 11211-8465
Mailing address
55 Saint Pauls PL
Mount Vernon, NY 10550-4933
Phone (718) 536-7470
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)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006008-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410480000000",
"number": "1558762260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 SAINT PAULS PL",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105504933",
"telephone_number": "718-536-7470",
"fax_number": "914-668-5029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "678 GRAND ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112118465",
"telephone_number": "718-782-5907",
"fax_number": "718-782-5917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHEWS",
"first_name": "NORMAN",
"credential": "P.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-12",
"last_updated": "2014-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "006008-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.