Active NPI
Matthew Tyler Hunter, DO
- Psychiatry Physician
- Fort Drum, NY
National Provider Identifier
1831696426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0102205904
- Practice address
- P36 1St St. W
Fort Drum, NY 13650 - Phone
- (315) 772-2557
- NPI assigned
- Apr 10, 2018
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | V0736 | TX | |
| Psychiatry Physician | 2084P0800X | 0102205904 | VA | Primary |
Addresses
Primary practice location
P36 1St St. W
Fort Drum, NY 13650
Mailing address
11050 Mount Belvedere Blvd
Fort Drum, NY 13602
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| V0736 | TX | MD | Psychiatry Physician |
| 0102205904 | VA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741046400000",
"number": "1831696426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11050 MOUNT BELVEDERE BLVD",
"city": "FORT DRUM",
"state": "NY",
"postal_code": "13602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "P36 1ST ST. W",
"city": "FORT DRUM",
"state": "NY",
"postal_code": "13650",
"telephone_number": "315-772-2557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNTER",
"first_name": "MATTHEW",
"middle_name": "TYLER",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-10",
"last_updated": "2025-03-04",
"certification_date": "2025-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "V0736",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0102205904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Drum, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.