Mark Anthony Matesich, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

011157 Issued in NY

Practice address

496 Pearl St
Buffalo, NY 14202-1904

Phone

(716) 759-4747

NPI assigned

May 11, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1568952885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 KNOX AVE LOWR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142163310",
            "telephone_number": "716-759-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 PEARL ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021904",
            "telephone_number": "716-759-4747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1002 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142221202",
            "country_code": "US",
            "telephone_number": "716-759-4747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATESICH",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-11",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "011157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mawra Masud, M.D.
• MD Shohel Masud
• Nour Masud, DDS
• Taylor Masur, FNP
• Josh Michael Matecki, PA-C
• Scott Christopher Matheis Jr.
• Deborah Matheron, MS, CCC-SLP
• Bobby Mathew, MBBS
• Dawn Marie Mathews, MSED, CCC/SLP
• Hannah Rose Mathieson

• Chiropractor in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2018; 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.