Alice Matukaitis, CRNP

Primary specialty

Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X

License

RN507564L Issued in PA

Practice address

10 E Independence St
Shamokin, PA 17872-6804

Phone

(570) 648-0582

NPI assigned

Nov 13, 2006

Last updated

Mar 6, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Family Planning Services of Sun/ Women's Health Services of MJ

  • Voluntary or Charitable Agency
  • Lewisburg, PA
  • NPI 1043268568
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1700957214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4612 WESTBRANCH HWY",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "17837",
            "telephone_number": "570-523-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E INDEPENDENCE ST",
            "city": "SHAMOKIN",
            "state": "PA",
            "postal_code": "178726804",
            "telephone_number": "570-648-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUKAITIS",
        "first_name": "ALICE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "PA",
            "license": "RN507564L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NO.",
            "identifier": "50004271",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NO.",
            "identifier": "MA1332162",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• L&S Home Care Agency LLC
• Dawn Michelle Lenker, PA-C
• Stephen A Madden, DDS
• Philip L. Manney, BA, BS, D.C.
• Nadine Markovich-Sten, PA-C
• Melissa Ann Menapace, RPH
• Merakey Pennsylvania
• Garrette C. Michaels, DPT
• Miller Donmoyer Family Health Center LLC
• Aaron Miller, O.D.

• Ambulatory Women's Health Care Registered Nurse in Shamokin, PA
• Providers in Shamokin, PA by specialty
• Ambulatory Women's Health Care Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; 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.