NPIMap

Individual provider Active NPI

Joseph Salvador Matarese, PA-C

  • Physician Assistant
  • Concord, NC
National Provider Identifier
1942305446
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01142 Issued in NC
Practice address
301 Hawthorne Lane
Suite 200
Concord, NC 28004
Phone
(704) 316-5100
Fax
(704) 316-5101
NPI assigned
Sep 13, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-01142 NC Primary
Surgical Physician Assistant 363AS0400X 0010-01142 NC
Surgical Physician Assistant 363AS0400X 1287 MA

Addresses

Primary practice location

301 Hawthorne Lane
Suite 200
Concord, NC 28004

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-5100

Other identifiers 1

IdentifierTypeStateIssuer
1942305446MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmatarese37779@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071213000368 NC Practitioner - Physician Assistant 4688764731 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 343-9800

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1287MAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Medical Group, Inc. CurrentSince Jun 21, 2010 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 17, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jun 21, 2010 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Mar 7, 2025 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 17, 2020 Accepting new patients
Cardiothoracic and Vascular Surgeons, P.C. Surgical Past Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients
Hartford Clinical Associates, PC Past Accepting new patients

Locations

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

301 Hawthorne Ln
Ste 200
Charlotte, NC 28204
Phone (704) 316-5100

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 11

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1942305446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-5100",
            "fax_number": "704-316-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HAWTHORNE LANE",
            "address_2": "SUITE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28004",
            "telephone_number": "704-316-5100",
            "fax_number": "704-316-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATARESE",
        "first_name": "JOSEPH",
        "middle_name": "SALVADOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01142",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-01142",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "1287",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942305446",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmatarese37779@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "301 Hawthorne Lane",
            "address_2": "Suite 200",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.