Matthew Vanvliet, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

034166 Issued in NY

Practice address

105 Marys Ave
Kingston, NY 12401-5829

Phone

(845) 334-2890

NPI assigned

Aug 6, 2025

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 NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Physicians Medical Associates New York PC

  • Emergency Medicine Physician
  • Syracuse, NY
  • NPI 1073386421
  Medicare reassignment

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

{
    "created_epoch": "1754438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1619852035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 LINDORF ST",
            "city": "ULSTER PARK",
            "state": "NY",
            "postal_code": "124875009",
            "telephone_number": "845-706-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MARYS AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015829",
            "telephone_number": "845-334-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANVLIET",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Rose Vandeusen, LMT
• Mary Vandezande, LCSW
• Rebecca Marie Vanduzer
• Dale Edward Vangaasbeek, PHD
• Karen A Vanleuven, RN
• Debra A. Vargas
• Luciana Hubner Vargas, LPN
• Rochak Varma, M.D.
• Vassar Brothers Hospital Ulster Radiation Oncology Center
• Renee Leigh Vaughn, LMT, NCTMB

• Physician Assistant in Kingston, NY
• Providers in Kingston, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.