Individual provider Active NPI

Malkiel Matatov

  • Registered Nurse
  • New York, NY
National Provider Identifier
1619889623
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
715566 Issued in NY
Practice address
30 Broad St
New York, NY 10004-2304
Phone
(917) 228-5600
NPI assigned
Sep 22, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 715566 NY Primary

Addresses

Primary practice location

30 Broad St
New York, NY 10004-2304

Mailing address

6510 99TH St Apt 5E
Rego Park, NY 11374-3536
Phone (646) 348-0651

Other practice location 1

6510 99th St Apt 5E
Rego Park, NY 11374-3536
Phone (646) 348-0651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1619889623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 99TH ST APT 5E",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743536",
            "telephone_number": "646-348-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BROAD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042304",
            "telephone_number": "917-228-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6510 99th St Apt 5E",
            "address_purpose": "LOCATION",
            "city": "Rego Park",
            "state": "NY",
            "postal_code": "113743536",
            "country_code": "US",
            "telephone_number": "646-348-0651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATATOV",
        "first_name": "MALKIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "715566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.