Boris Matusevich, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

217094-1 Issued in NY

Practice address

1175 Montauk Hwy
Suite 1
West Islip, NY 11795-4939

Phone

(631) 321-0570

NPI assigned

Mar 10, 2006

Last updated

Mar 3, 2008By the provider in NPPES

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Island Gastroenterology Consultants PCGroup PAC ID 8921999079, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Island Gastroenterology Consultants PC

  • Specialist
  • West Islip, NY
  • NPI 1174556963
  Medicare reassignment Care Compare group NPD
• Boris Matusevich Physician PC

  • Anesthesiology Physician
  • West Islip, NY
  • NPI 1386890960
  Authorized official Same address or phone
• Mount Sinai School of Medicine

  dba Mount Sinai Elmhurst Faculty Practice Group

  • Internal Medicine Physician
  • Elmhurst, NY
  • NPI 1013147313
  NPD (past)
• Physician Consulting, PC

  • Anesthesiology Physician
  • New York, NY
  • NPI 1437127222
  NPD (past)
• Robert Bernholc MD PC

  • Anesthesiology Physician
  • Setauket, NY
  • NPI 1972640761
  NPD (past)

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1952379356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 BETH LN",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981544",
            "telephone_number": "516-374-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 MONTAUK HWY",
            "address_2": "SUITE 1",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954939",
            "telephone_number": "631-321-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUSEVICH",
        "first_name": "BORIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "217094-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Mastorides, LMSW
• Kolathu A Mathew, M.D.
• Lincy Mathew
• Shelley Matson, RN
• Michael Ferdinando Matteis, DO
• Christine Elizabeth McCann
• Lisa McCarthy
• Janice McCormack, MD
• William E McCormick, MD
• Jocelyn Jerusha McCullough, DO

• Anesthesiology Physician in West Islip, NY
• Providers in West Islip, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.