Individual provider Active NPI

Colleen Matejicka, D.O.

  • Rheumatology Physician
  • Lancaster, PA
National Provider Identifier
1790768828
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
OS009984L Issued in PA
Practice address
2108 Harrisburg Pike
Suite 200
Lancaster, PA 17601-2644
Phone
(717) 299-1301
Fax
(717) 299-2214
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X OS009984L PA Primary

Addresses

Primary practice location

2108 Harrisburg Pike
Suite 200
Lancaster, PA 17601-2644

Mailing address

2108 Harrisburg Pike
Suite 200
Lancaster, PA 17601-2644
Phone (717) 299-1301

Other identifiers 7

IdentifierTypeStateIssuer
0018997900001MedicaidPA
1062166OtherPAAETNA HMO
1527199OtherPAGATEWAY HEALTH PLAN
7990688OtherPAAETNA NON-HMO
H62859OtherPAHEALTH ASSURANCE
1390245OtherPAHIGHMARK BLUE SHIELD
50000922OtherPACAPITAL BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100128000331 PA Practitioner - Rheumatology 8820130826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Philadelphia College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

1261 Division Hwy
Ephrata, PA 17522-8822

1261 Division Hwy 2
Ephrata, PA 17522-8822
Phone (717) 738-5544

2100 Harrisburg Pike
Suite 2112
Lancaster, PA 17601-2644
Phone (717) 544-3216

2102 Harrisburg Pike
Lancaster, PA 17601-2644
Phone (717) 544-9400

2104 Harrisburg Pike
Suite 200
Lancaster, PA 17601-2644
Phone (717) 544-3626

2106 Harrisburg Pike
Lancaster, PA 17601-2644

2108 Harrisburg Pike
Lancaster, PA 17601-2644

2110 Harrisburg Pike
Lancaster, PA 17601-2644

2112 Harrisburg Pike
Lancaster, PA 17601-2644

2150 Harrisburg Pike
Suite 200a
Lancaster, PA 17601-2644
Phone (717) 544-3059

3045 Marietta Ave
Lancaster, PA 17601-1321
Phone (717) 299-4644

418 Cloverleaf Rd
Elizabethtown, PA 17022-9320
Phone (717) 627-7696

426 Cloverleaf Rd
Elizabethtown, PA 17022-9320
Phone (717) 393-1900

432 Cloverleaf Rd
Elizabethtown, PA 17022-9320
Phone (717) 544-6350

554 N Duke St
LGHP Penn Med Plastic and Cosmetic Surgery
Lancaster, PA 17602-2250
Phone (717) 291-5863

555 N Duke St
Lancaster, PA 17602-2250

555 N Duke St 1St Floor
LGHP Penn Medicine Behavioral Health
Lancaster, PA 17602-2250
Phone (717) 560-3782

Hospital & facility affiliations

  • Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100
  • Wellspan Ephrata Community Hospital Hospital, Ephrata, PA, CCN 390225
  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Reading Hospital Hospital, West Reading, PA, CCN 390044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS009984LPAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group CurrentSince Aug 15, 2002 Accepting new patients
Lancaster General Medical Group Current Accepting new patients
Lancaster General Medical Group CurrentSince Aug 15, 2002 Accepting new patients
Lancaster General Medical Group Past Accepting new patients
Lancaster General Medical Group Past Accepting new patients

Locations

426 Cloverleaf Rd
Elizabethtown, PA 17022
Phone (717) 299-1301

1261 Division Hwy
#2
Ephrata, PA 17522
Phone (717) 299-1301

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

690 Good Dr
Ste 23
Lancaster, PA 17601
Phone (717) 299-1301

2108 Harrisburg Pike
Ste 200
Lancaster, PA 17601
Phone (717) 290-3555

2104 Harrisburg Pike
Ste 24
Lancaster, PA 17601
Phone (717) 299-1301

Interoperability endpoints

  • Direct secure messaging: cmatejicka1099@direct-lghealth.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 and National Provider Directory roles.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1790768828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 HARRISBURG PIKE",
            "address_2": "SUITE 200",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-299-1301",
            "fax_number": "717-299-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 HARRISBURG PIKE",
            "address_2": "SUITE 200",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-299-1301",
            "fax_number": "717-299-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEJICKA",
        "first_name": "COLLEEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "OS009984L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018997900001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1062166",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1527199",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON-HMO",
            "identifier": "7990688",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ASSURANCE",
            "identifier": "H62859",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1390245",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50000922",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.