Individual provider Active NPI

Lauren Matera, DO

  • Pediatric Adolescent Medicine Physician
  • Hawthorne, NY
National Provider Identifier
1780115246
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
322354 Issued in NY
Practice address
40 Saw Mill River Rd
Hawthorne, NY 10532-1535
Phone
(914) 304-5288
Fax
(914) 345-1755
NPI assigned
Mar 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 58.008380 OH
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Adolescent Medicine Physician 2080A0000X 322354 NY Primary

Addresses

Primary practice location

40 Saw Mill River Rd
Hawthorne, NY 10532-1535

Mailing address

40 Saw Mill River Rd
Hawthorne, NY 10532-1535
Phone (914) 304-5288

Other practice location 1

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231117002981 NY Practitioner - Pediatric Medicine 3577834068 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
58.008380OHMDPediatrics Physician
322354NYMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Children'S Health Physicians, LLP Pediatrics CurrentSince Oct 8, 2023 Accepting new patients
Boston Childrens Health Physicians LLP CurrentSince Oct 8, 2023 Accepting new patients
Westchester County Health Care Corporation Past Accepting new patients

Locations

40 Saw Mill River Rd
Hawthorne, NY 10532
Phone (914) 345-8888

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

400 Columbus Ave
Ste 200E
Valhalla, NY 10595
Phone (314) 400-4416

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: lauren.matera.p1@direct.cwpw.nextgenshare.com

Organizations & group practices 3

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": "1490400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1780115246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 SAW MILL RIVER RD",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105321535",
            "telephone_number": "914-304-5288",
            "fax_number": "914-345-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SAW MILL RIVER RD",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105321535",
            "telephone_number": "914-304-5288",
            "fax_number": "914-345-1755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "614-722-2458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATERA",
        "first_name": "LAUREN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-25",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "58.008380",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "322354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.