Active NPI
Keren Matveev, D.O.
- Family Medicine Physician
- Waltham, MA
National Provider Identifier
1649628728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 281587
- Practice address
- 75 Third Avenue
First Floor
Waltham, MA 02451 - Phone
- (781) 290-0100
- NPI assigned
- May 30, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 281587 | MA | Primary |
Addresses
Primary practice location
75 Third Avenue
First Floor
Waltham, MA 02451
Mailing address
200 Estate Dr Apt 206
Chestnut Hill, MA 02467-3539
Phone (617) 319-4887
Other practice location 1
550 1st Ave
NYU Langone Medical Center
New York, NY 10016-6402
Phone (212) 263-5506
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
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590537600000",
"number": "1649628728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 ESTATE DR APT 206",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024673539",
"telephone_number": "617-319-4887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 THIRD AVENUE",
"address_2": "FIRST FLOOR",
"city": "WALTHAM",
"state": "MA",
"postal_code": "02451",
"telephone_number": "781-290-0100"
}
],
"practiceLocations": [
{
"address_1": "550 1st Ave",
"address_2": "NYU Langone Medical Center",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100166402",
"country_code": "US",
"telephone_number": "212-263-5506",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATVEEV",
"first_name": "KEREN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-30",
"last_updated": "2020-05-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "281587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.