Matthew Ryan Bale-Pena, ATC, CSCS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

25MT00146300 Issued in NJ

Practice address

25 Olcott Ave
Bernardsville, NJ 07924-2307

Phone

(908) 204-1930

NPI assigned

Sep 30, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222732800000",
    "number": "1871744532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 COVENTRY CT",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "074571643",
            "telephone_number": "973-831-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 OLCOTT AVE",
            "city": "BERNARDSVILLE",
            "state": "NJ",
            "postal_code": "079242307",
            "telephone_number": "908-204-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALE-PENA",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "ATC, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00146300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maryam Banafti, MSW,LCSW
• Zachary Barnard, L.M.T.
• John M. Bearlepp, DDS
• Bernards Eye Care, LLC
• Bernardsville Pediatrics, LLC

• Athletic Trainer in Bernardsville, NJ
• Providers in Bernardsville, NJ by specialty
• Athletic Trainer in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.