Patricia Mary Matos-Puente, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

165700-1 Issued in NY

Practice address

5 Pitch Pine CT
Northport, NY 11768-2755

Phone

(631) 754-0765

Fax

(631) 963-3214

NPI assigned

Mar 22, 2006

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397260800000",
    "number": "1720047350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PITCH PINE CT",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682755",
            "telephone_number": "631-754-0765",
            "fax_number": "631-963-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PITCH PINE CT",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682755",
            "telephone_number": "631-754-0765",
            "fax_number": "631-963-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS-PUENTE",
        "first_name": "PATRICIA",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2014-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "165700-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "PO1269713",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01306725",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Alfred Mascolo, DMD
• Nicholas Marcello Mastroianni, D.D.S.
• Christina Eapen Mathai, M.D
• Cristin Mathiez, LCSW-R
• Stella E Matike, PT
• Nicole Margot Mauro
• Gina M Mazza, LMT
• Patricia Dudek McAdam, R.N.
• Christopher McDermott, LMHC
• Kaitlyn McGuire-Gilmore, LMT

• Internal Medicine Physician in Northport, NY
• Providers in Northport, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.