Heather Nicole Matejka, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

1002180 Issued in WI

Practice address

6226 14TH Ave
Kenosha, WI 53143-4413

Phone

(815) 861-2354

NPI assigned

Aug 30, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: heather.matejka.p1@direct.peakvista.nextgenshare.com

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.

• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1730166034
  Medicare reassignment NPD
• Peak Vista Community Health Centers

  dba Behavioral Health at Inside Out Youth Services

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1871347443
  NPD

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1609424837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 FARMINGTON LN",
            "city": "JOHNSBURG",
            "state": "IL",
            "postal_code": "600515175",
            "telephone_number": "815-861-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6226 14TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531434413",
            "telephone_number": "815-861-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEJKA",
        "first_name": "HEATHER",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1002180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hmatejka@atsu.edu",
            "affiliation": "N",
            "address_1": "6226 14th Ave",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531434413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Molly Mason, CRNA
• Ann Mastrostefano, COTA
• Nicholas Masyga
• Rodrigo A Mata Jr., M.D.
• Rodrigo Buencamino Mata III, M.D.
• Mathew McCarthy, MD, SC
• Mithin Mathew, DO
• Anitha Mathews, RPH
• Eugene Mathias
• Walter P Matoska, PHARMD

• Dentist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.