Individual provider Active NPI

Julie Elizabeth Matecki, MA CCC SLP/L

  • Speech-Language Pathologist
  • North Tonawanda, NY
National Provider Identifier
1881874303
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
015515 Issued in NY
Practice address
371 Roncroff Dr
North Tonawanda, NY 14120-5621
Phone
(716) 430-7363
NPI assigned
Nov 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL008948 PA
Speech-Language Pathologist 235Z00000X 015515 NY Primary

Addresses

Primary practice location

371 Roncroff Dr
North Tonawanda, NY 14120-5621

Mailing address

37 Hamilton Blvd
Kenmore, NY 14217-1907
Phone (716) 430-7363

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
SL008948PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1881874303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 HAMILTON BLVD",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171907",
            "telephone_number": "716-430-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 RONCROFF DR",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141205621",
            "telephone_number": "716-430-7363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATECKI",
        "first_name": "JULIE",
        "middle_name": "ELIZABETH",
        "credential": "MA CCC SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL008948",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "015515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.