Individual provider Active NPI

Juliette M Matis, OT

  • Occupational Therapist
  • Boca Raton, FL
National Provider Identifier
1669480364
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT12179 Issued in FL
Practice address
9980 Central Park Blvd N Ste 102
Boca Raton, FL 33428-1703
Phone
(561) 470-2205
Fax
(561) 470-2215
NPI assigned
Aug 4, 2006
Last updated
Dec 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT12179 FL Primary

Addresses

Primary practice location

9980 Central Park Blvd N Ste 102
Boca Raton, FL 33428-1703

Mailing address

9980 Central Park Blvd N Ste 102
Boca Raton, FL 33428-1703
Phone (561) 470-2205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061025000550 FL Practitioner - Occupational Therapist in Private Practice 1456358944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9980 Central Park Blvd N
Boca Raton, FL 33428-1703
Phone (561) 470-2205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT12179FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hands With Care Occupational Therapy and Rehabilitation LLC Occupational Therapist CurrentSince Jun 25, 2007 Accepting new patients
Jennifer H Forman MSPT PA PastSince Nov 1, 2004 Accepting new patients
Joyner Hand, PA Past Accepting new patients
Joseph E Gillespie Inc Past Accepting new patients

Locations

9980 Central Park Blvd N
Ste 102
Boca Raton, FL 33428
Phone (561) 470-2205

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1669480364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9980 CENTRAL PARK BLVD N STE 102",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334281703",
            "telephone_number": "561-470-2205",
            "fax_number": "561-470-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9980 CENTRAL PARK BLVD N STE 102",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334281703",
            "telephone_number": "561-470-2205",
            "fax_number": "561-470-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIS",
        "first_name": "JULIETTE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT12179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.