Christine Ann Matijas, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

331655 Issued in NY

Practice address

60 Main Street
Port Byron, NY 13140

Phone

(315) 776-9700

NPI assigned

Jul 25, 2006

Last updated

Dec 18, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Christine Griswold Matijas Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Loretto Rest Realty Corporation

  • Clinic/Center
  • Syracuse, NY
  • NPI 1548366271
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1780606798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MAIN ST.",
            "city": "PORT BYRON",
            "state": "NY",
            "postal_code": "13140",
            "telephone_number": "315-497-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MAIN STREET",
            "city": "PORT BYRON",
            "state": "NY",
            "postal_code": "13140",
            "telephone_number": "315-776-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIJAS",
        "first_name": "CHRISTINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "331655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01752616",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "MATIJAS",
            "middle_name": "GRISWOLD",
            "prefix": "MRS.",
            "credential": "NURSE PRACTITIONER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Meghan E Hutchings, FNP
• Margaret Jenner, LPN
• Amanda Lee Jennings
• Christi Grace Littlefield, LPN
• Catherine M Manrow
• Kaintigern Adian Meaker, LPN
• Port Byron Central School District
• Port Byron Fire Department
• Sarah-Anne Monique Rindfleisch, RN
• Julie A Soule, HYG

• Family Nurse Practitioner in Port Byron, NY
• Providers in Port Byron, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.