Robert N Matiasevich Jr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

44511 Issued in CA

Practice address

1775 Dominican Way
Santa Cruz, CA 95065

Phone

(831) 476-7272

Fax

(831) 476-1446

NPI assigned

Feb 7, 2007

Last updated

Feb 12, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

Herman Ostrow School of Dentistry of Usc, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Robert Matiasevich Jr DDS Inc

  • Dentist
  • Santa Cruz, CA
  • NPI 1235278441
  Medicare reassignment NPD

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1598805996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 DOMINICAN WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95065",
            "telephone_number": "831-476-7272",
            "fax_number": "831-476-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 DOMINICAN WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95065",
            "telephone_number": "831-476-7272",
            "fax_number": "831-476-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIASEVICH",
        "first_name": "ROBERT",
        "middle_name": "N",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "44511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rashmi Mathew, MD
• Christie Mathews
• Peggy Mathewson, SLP
• Sofia Juliette Mathis
• Robert N Matiasevich Sr., DDS
• Amanda Matos
• Haruna Matsusaka
• Gina Matthews
• Kristi Jonea Matthews, REGISTERED DIETITIAN
• Zoe Mattingly

• Dentist in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.