Individual provider Active NPI

Aleksandr I Matayev

  • Clinical Psychologist
  • Rego Park, NY
National Provider Identifier
1780530634
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
028062 Issued in NY
Practice address
6260 99TH St Apt 507
Rego Park, NY 11374-6017
Phone
(917) 929-3040
NPI assigned
Mar 4, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 028062 NY Primary

Addresses

Primary practice location

6260 99TH St Apt 507
Rego Park, NY 11374-6017

Mailing address

6260 99TH St Apt 507
Rego Park, NY 11374-6017
Phone (917) 929-3040

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260604004013 NY Practitioner - Clinical Psychologist 1557832003 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Che Senior Psychological Services, PCGroup PAC ID 8022905314, 227 clinicians

Practice addresses (Care Compare)

300 Cadman PLZ W
Brooklyn, NY 11201-3211
Phone (888) 515-3834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

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": "1772582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1780530634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6260 99TH ST APT 507",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113746017",
            "telephone_number": "917-929-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6260 99TH ST APT 507",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113746017",
            "telephone_number": "917-929-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAYEV",
        "first_name": "ALEKSANDR",
        "middle_name": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "028062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.