Individual provider Active NPI

Sarah Matura

  • Assisted Living Facility
  • Brooklyn Park, MN
National Provider Identifier
1679285753
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
39469 Issued in MN
Practice address
2340 Edinbrook Ter
Brooklyn Park, MN 55443-3731
Phone
(404) 924-5791
NPI assigned
Dec 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 39469 MN Primary

Addresses

Primary practice location

2340 Edinbrook Ter
Brooklyn Park, MN 55443-3731

Mailing address

2340 Edinbrook Ter
Brooklyn Park, MN 55443-3731
Phone (404) 924-5791

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
39469MNMDAssisted Living Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Paradise Living LLC Assisted Living Facility CurrentSince Feb 12, 2023 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": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1679285753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 EDINBROOK TER",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554433731",
            "telephone_number": "404-924-5791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 EDINBROOK TER",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554433731",
            "telephone_number": "404-924-5791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATURA",
        "first_name": "SARAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-20",
        "last_updated": "2022-12-20",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "39469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.