Active NPI
Alla Matsievskaya, M.D.
- Pediatrics Physician
- Warwick, RI
National Provider Identifier
1720190267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD09819
- Practice address
- 430 Toll Gate Rd
Warwick, RI 02886-2715 - Phone
- (401) 737-4343
- Fax
- (401) 734-9365
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD09819 | RI | Primary |
Addresses
Primary practice location
430 Toll Gate Rd
Warwick, RI 02886-2715
Mailing address
430 Toll Gate Rd
Warwick, RI 02886-2715
Phone (401) 737-4343
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201848 | Other | RI | HARVARD PILGRIM HEALTH |
| 2499938 | Other | RI | AETNA |
| 12-06001 | Other | RI | UNITED HEALTH CARE |
| RI2988 | Other | RI | ACS/HEALTHNET |
| 403352 | Other | RI | BLUE CHIP |
| AM35406 | Medicaid | RI | |
| 1920 | Other | RI | NEIGHBORHOOD HEALTH |
| 23287-4 | Other | RI | BLUE CROSS BLUE SHIELD RI |
| 406471 | Other | RI | TUFTS |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD09819 | RI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720190267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 TOLL GATE RD",
"city": "WARWICK",
"state": "RI",
"postal_code": "028862715",
"telephone_number": "401-737-4343",
"fax_number": "401-734-9365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 TOLL GATE RD",
"city": "WARWICK",
"state": "RI",
"postal_code": "028862715",
"telephone_number": "401-737-4343",
"fax_number": "401-734-9365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATSIEVSKAYA",
"first_name": "ALLA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "RI",
"license": "MD09819",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTH",
"identifier": "201848",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2499938",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "12-06001",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACS/HEALTHNET",
"identifier": "RI2988",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "403352",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "AM35406",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH",
"identifier": "1920",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD RI",
"identifier": "23287-4",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "406471",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.