Individual provider Active NPI

Jennifer Raye-Mattero, PA-C

  • Physician Assistant
  • Inwood, NY
National Provider Identifier
1851751713
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019568 Issued in NY
Practice address
271 Doughty Blvd
Inwood, NY 11096-2135
Phone
(516) 371-6884
Fax
(516) 371-6083
NPI assigned
Mar 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 019568 NY Primary

Addresses

Primary practice location

271 Doughty Blvd
Inwood, NY 11096-2135

Mailing address

701 Main St
East Hartford, CT 06108-3126
Phone (860) 289-5561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210825003683 CT Practitioner - Physician Assistant 8527355262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Urgent Care Centers LLCGroup PAC ID 7618242777, 201 clinicians

Practice addresses (Care Compare)

1025 Silas Deane Hwy
Wethersfield, CT 06109-4223
Phone (860) 696-2400

112 S Main St
Torrington, CT 06790-6429
Phone (860) 387-4365

1215 Farmington Ave
Bristol, CT 06010-4703
Phone (860) 516-5931

1445 New Britain Ave
West Hartford, CT 06110-1659
Phone (860) 317-9787

175 Webster Square Rd
Berlin, CT 06037-2328
Phone (860) 200-8095

240 Spencer St
Manchester, CT 06040-4618
Phone (860) 474-3963

336 N Main St
West Hartford, CT 06117-2675
Phone (860) 200-7701

35 Talcottville Rd
Vernon, CT 06066-5261
Phone (860) 787-5774

385 W Main St
Avon, CT 06001-4357
Phone (860) 777-6977

40 Fenn Rd
Newington, CT 06111-2212
Phone (860) 777-1283

54 Hazard Ave
Enfield, CT 06082-3845
Phone (860) 787-5780

7 Mill Pond Dr
Suite a
Granby, CT 06035-2637
Phone (860) 323-3164

775 Queen St
Southington, CT 06489-1531
Phone (860) 777-1281

875 E Main St
Meriden, CT 06450-6006
Phone (475) 343-3483

99 Executive Blvd
Suite 105
Southington, CT 06489-6029
Phone (860) 384-7847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA CurrentSince Sep 20, 2021 Accepting new patients
American Current Care P.a. CurrentSince Sep 20, 2021 Accepting new patients

Locations

701 Main St
East Hartford, CT 06108
Phone (860) 289-5561

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1851751713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083126",
            "telephone_number": "860-289-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 DOUGHTY BLVD",
            "city": "INWOOD",
            "state": "NY",
            "postal_code": "110962135",
            "telephone_number": "516-371-6884",
            "fax_number": "516-371-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYE-MATTERO",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-03",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inwood, NY

Sources for this page

Verify at the official NPI Registry.