Individual provider Active NPI

Matthew Delmastro, APRN

  • Nurse Practitioner
  • Greenwich, CT
National Provider Identifier
1669937959
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7396 Issued in CT
Practice address
15 Valley Dr Ste 200
Greenwich, CT 06831-5205
Phone
(203) 863-4210
Fax
(203) 622-1872
NPI assigned
Jan 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7396 CT Primary

Addresses

Primary practice location

15 Valley Dr Ste 200
Greenwich, CT 06831-5205

Mailing address

31 Tanglewood LN
Naugatuck, CT 06770-1619
Phone (203) 528-1204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190329000587 CT Practitioner - Nurse Practitioner 4183964141 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7396CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince May 7, 2019 Accepting new patients
Yale University CurrentSince May 7, 2019 Accepting new patients
Northeast Medical Group, Inc. Nurse Practitioner Past Accepting new patients

Locations

15 Valley Dr
Ste 200
Greenwich, CT 06831
Phone (203) 863-3008

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

789 Howard Ave
North Haven, CT 06519
Phone (203) 688-2471

Interoperability endpoints

  • Direct secure messaging: mdelmastro326682@direct.ynhh.org

Organizations & group practices 3

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": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1669937959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 TANGLEWOOD LN",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067701619",
            "telephone_number": "203-528-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 VALLEY DR STE 200",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315205",
            "telephone_number": "203-863-4210",
            "fax_number": "203-622-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELMASTRO",
        "first_name": "MATTHEW",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "7396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.