Individual provider Active NPI

Sherry A Matook, APRN,CNP

  • Family Nurse Practitioner
  • Providence, RI
National Provider Identifier
1881828929
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN01258 Issued in RI
Practice address
101 Dudley St
Providence, RI 02905-2401
Phone
(401) 274-1100
NPI assigned
May 4, 2009
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN01258 RI Primary
Specialist 174400000X NPP37472 RI

Addresses

Primary practice location

101 Dudley St
Providence, RI 02905-2401

Mailing address

31 Agawam Park Rd
Rumford, RI 02916-1603
Phone (401) 437-6430

Other identifiers 2

IdentifierTypeStateIssuer
37472OtherNEONATAL
NPP 37472OtherRINPP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20160919002343 RI Practitioner - Nurse Practitioner 7911294921 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NPP37472RIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Spring Health Care Management, Inc. CurrentSince May 1, 2022 Accepting new patients
Silver Spring Health Care Management, Inc. Family Current Accepting new patients
Silver Spring Health Care Management, Inc. Specialist CurrentSince May 1, 2022 Accepting new patients
Seacoast Eye Associates Inc Past Accepting new patients
John Jefferys Bandola, M.D. PastSince Feb 1, 2010 Accepting new patients

Locations

100 Kenyon Ave
Wakefield, RI 02879
Phone (401) 782-8000

70 Kenyon Ave
#211
Wakefield, RI 02879
Phone (401) 471-6285

70 Kenyon Ave
Unit 211
Wakefield, RI 02879
Phone (401) 789-8543

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1881828929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 AGAWAM PARK RD",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029161603",
            "telephone_number": "401-437-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052401",
            "telephone_number": "401-274-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOOK",
        "first_name": "SHERRY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "APRN,CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-04",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN01258",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "RI",
            "license": "NPP37472",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEONATAL",
            "identifier": "37472",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPP",
            "identifier": "NPP 37472",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.