Active NPI
Jay Matut, MD
- Obstetrics Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics Physician
- License
- 201576
- Practice address
- 90 Maiden LN RM 300
New York, NY 10038-4725 - Phone
- (646) 290-9560
- NPI assigned
- Mar 31, 2006
- Last updated
- Sep 14, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 054294 | CT | |
| Obstetrics Physician | 207VX0000X | 201576 | NY | Primary |
Addresses
Primary practice location
90 Maiden LN RM 300
New York, NY 10038-4725
Mailing address
90 Maiden LN RM 300
New York, NY 10038-4725
Phone (646) 290-9560
Other practice location 1
7901 4th St N Ste 300
St Petersburg, FL 33702-4399
Phone (646) 290-9560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01936965 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054294 | CT | MD | Obstetrics & Gynecology Physician |
| 201576 | NY | MD | Obstetrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maiden Lane Medical, PLLC | Current | Accepting new patients | |
| St.Uke's - West Care Medical Associates | Past | Accepting new patients | |
| Allara Medical Group PA | Obstetrics & Gynecology | Past | Accepting new patients |
| Ny Pelvic Pain and Minimally Invasive Gynecologic Surgery PC | Past | Accepting new patients |
Locations
90 Maiden Ln
Fl 3
New York, NY 10038
Phone (646) 290-9560
90 Maiden Ln
Rm 300
New York, NY 10038
Phone (646) 240-4560
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EEDBDA
- jmatut@hiemail.healtheconnections.org
Organizations & group practices 5
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.
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CT
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- Gynecology Physician
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- NPI 1710022140
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- Internal Medicine Physician
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789344000000",
"number": "1760443394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 MAIDEN LN RM 300",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100384725",
"telephone_number": "646-290-9560",
"fax_number": "212-532-4362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 MAIDEN LN RM 300",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100384725",
"telephone_number": "646-290-9560"
}
],
"practiceLocations": [
{
"address_1": "7901 4th St N Ste 300",
"address_purpose": "LOCATION",
"city": "St Petersburg",
"state": "FL",
"postal_code": "337024399",
"country_code": "US",
"telephone_number": "646-290-9560",
"fax_number": "212-532-4362",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATUT",
"first_name": "JAY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2026-09-14",
"certification_date": "2026-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CT",
"license": "054294",
"primary": false
},
{
"code": "207VX0000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Obstetrics",
"state": "NY",
"license": "201576",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01936965",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; 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.