Active NPI
Elizabeth Ruel Matern, M.D. PSYCHIATRIST
- Psychiatry Physician
- Avon, CT
National Provider Identifier
1699979542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 048027
- Practice address
- 40 Dale Road
Suite 201
Avon, CT 06001 - Phone
- (860) 676-9350
- Fax
- (860) 678-7178
- NPI assigned
- Jun 13, 2007
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 243816 | NY | |
| Psychiatry Physician | 2084P0800X | 243816 | NY | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 243816 | NY | |
| Psychiatry Physician | 2084P0800X | 048027 | CT | Primary |
Addresses
Primary practice location
40 Dale Road
Suite 201
Avon, CT 06001
Mailing address
40 Dale Road
Suite 201
Avon, CT 06001
Phone (860) 676-9350
Other names 1
- Ms. Elizabeth Mary Ruel
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048027 | CT | MD | Psychiatry Physician |
| 243816 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1699979542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 DALE ROAD",
"address_2": "SUITE 201",
"city": "AVON",
"state": "CT",
"postal_code": "06001",
"telephone_number": "860-676-9350",
"fax_number": "860-678-7178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 DALE ROAD",
"address_2": "SUITE 201",
"city": "AVON",
"state": "CT",
"postal_code": "06001",
"telephone_number": "860-676-9350",
"fax_number": "860-678-7178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATERN",
"first_name": "ELIZABETH",
"middle_name": "RUEL",
"name_prefix": "Dr.",
"credential": "M.D. PSYCHIATRIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-13",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "243816",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "243816",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NY",
"license": "243816",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "048027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "RUEL",
"middle_name": "MARY",
"prefix": "MS.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.