Jose Manuel Mateo-Bermudez, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD037962E Issued in PA

Practice address

1900 John F Kennedy Blvd
Apt 1907
Philadelphia, PA 19103-1440

Phone

(215) 575-0730

NPI assigned

May 23, 2007

Last updated

Jan 31, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233360000000",
    "number": "1619187051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 JOHN F KENNEDY BLVD",
            "address_2": "APT 1907",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031440",
            "telephone_number": "215-575-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 JOHN F KENNEDY BLVD",
            "address_2": "APT 1907",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031440",
            "telephone_number": "215-575-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEO-BERMUDEZ",
        "first_name": "JOSE",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2009-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "13817",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD037962E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ashritha Matcha, DPM
• Ewa G Matczak, DMD
• Lori M. Matczak, RN
• Marco J Matejka, CRNA
• Madison Nicole Matello, PA-C
• Alina M Mateo, M.D.
• Sara Mateo, MD
• Maternity Care Coalition
• Susan Matesanz, MD
• Lauren Matesich

• Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.