Individual provider Active NPI

Richard Gene Matera I, D.C.

  • Chiropractor
  • Menlo Park, CA
National Provider Identifier
1639352701
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
26975DC Issued in CA
Practice address
1220 University Dr
Suite 202
Menlo Park, CA 94025-4262
Phone
(650) 838-1170
Fax
(650) 323-1174
NPI assigned
Dec 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 26975DC CA Primary

Addresses

Primary practice location

1220 University Dr
Suite 202
Menlo Park, CA 94025-4262

Mailing address

1220 University Dr
Suite 202
Menlo Park, CA 94025-4262
Phone (650) 838-1170

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26975DCCAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Craig Alan Davis Chiropractor Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1639352701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 UNIVERSITY DR",
            "address_2": "SUITE 202",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254262",
            "telephone_number": "650-838-1170",
            "fax_number": "650-323-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 UNIVERSITY DR",
            "address_2": "SUITE 202",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254262",
            "telephone_number": "650-838-1170",
            "fax_number": "650-323-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATERA",
        "first_name": "RICHARD",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "26975DC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.