Active NPI
Mary Mavromatis
- Psychiatry Physician
- Nyack, NY
National Provider Identifier
1629109012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 136733
- Practice address
- 131 Highmount Ave
Nyack, NY 10960-1508 - Phone
- (845) 358-7219
- Fax
- (845) 358-7234
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 136733 | NY | Primary |
Addresses
Primary practice location
131 Highmount Ave
Nyack, NY 10960-1508
Mailing address
131 Highmount Ave
Nyack, NY 10960-1508
Phone (845) 358-7219
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 8, 2017 through Jan 8, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 136733 | NY | MD | Psychiatry Physician |
Interoperability endpoints
- mmavromatis@hiemail.healtheconnections.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629109012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 HIGHMOUNT AVE",
"city": "NYACK",
"state": "NY",
"postal_code": "109601508",
"telephone_number": "845-358-7219",
"fax_number": "845-358-7234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 HIGHMOUNT AVE",
"city": "NYACK",
"state": "NY",
"postal_code": "109601508",
"telephone_number": "845-358-7219",
"fax_number": "845-358-7234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAVROMATIS",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "136733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nyack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.