Individual provider Active NPI

Patty Ellen Matz, PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1932175668
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0146101 Issued in NY
Practice address
315 Madison Ave RM 2200
New York, NY 10017-5428
Phone
(917) 375-9875
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0146101 NY Primary

Addresses

Primary practice location

315 Madison Ave RM 2200
New York, NY 10017-5428

Mailing address

209 W 97TH St
Apt 5E
New York, NY 10025-5601
Phone (917) 375-9875

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041014001263 NY Practitioner - Clinical Psychologist 5799745626 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
New York University Medical College - NLG, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

209 W 97TH St
Apt 5E
New York, NY 10025-5604

274 Madison Ave
RM 704
New York, NY 10016-0718
Phone (917) 375-9875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0146101NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1932175668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W 97TH ST",
            "address_2": "APT 5E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255601",
            "telephone_number": "917-375-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MADISON AVE RM 2200",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175428",
            "telephone_number": "917-375-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZ",
        "first_name": "PATTY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0146101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.