Individual provider Active NPI

Jeff Matranga, PH.D., ABPP

  • Health Service Psychologist
  • Waterville, ME
National Provider Identifier
1871500090
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
PS679 Issued in ME
Practice address
30 Chase Ave
Waterville, ME 04901-4624
Phone
(207) 872-4100
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X PS679 ME Primary

Addresses

Primary practice location

30 Chase Ave
Waterville, ME 04901-4624

Mailing address

2 Big Sky LN
Waterville, ME 04901-4340
Phone (207) 872-4100

Other identifiers 1

IdentifierTypeStateIssuer
231910099MedicaidME

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)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Health Psych Maine LLC Health Service CurrentSince Oct 17, 2019 Accepting new patients

Locations

2 Big Sky Ln
Waterville, ME 04901
Phone (207) 872-5800

Organizations & group practices 1

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1871500090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BIG SKY LN",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014340",
            "telephone_number": "207-872-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CHASE AVE",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014624",
            "telephone_number": "207-872-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATRANGA",
        "first_name": "JEFF",
        "name_prefix": "Dr.",
        "credential": "PH.D., ABPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "ME",
            "license": "PS679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231910099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.