Individual provider Active NPI

Maurya Materazzo, MA

  • Marriage & Family Therapist
  • Jamaica Plain, MA
National Provider Identifier
1730686288
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1696 Issued in MA
Practice address
28 Halifax St
Jamaica Plain, MA 02130-4307
Phone
(617) 712-2350
NPI assigned
Apr 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1696 MA Primary

Addresses

Primary practice location

28 Halifax St
Jamaica Plain, MA 02130-4307

Mailing address

PO Box 300195
Jamaica Plain, MA 02130-0002
Phone (781) 429-7755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423003611 MA Practitioner - Marriage and Family Therapist 1951740992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1696MAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Maron Dga PC PastSince May 1, 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": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1730686288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 300195",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021300002",
            "telephone_number": "781-429-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 HALIFAX ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304307",
            "telephone_number": "617-712-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATERAZZO",
        "first_name": "MAURYA",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "1696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.