Active NPI
Paul Anthony Matera X, M.D.
- Internal Medicine Physician
- Washington, DC
National Provider Identifier
1952420531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD17571
- Practice address
- 920 Varnum St NE
Washington, DC 20017-2145 - Phone
- (202) 269-7400
- NPI assigned
- Mar 28, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD17571 | DC | Primary |
Addresses
Primary practice location
920 Varnum St NE
Washington, DC 20017-2145
Mailing address
515 Kansala Dr
Annapolis, MD 21401-8101
Phone (410) 573-1884
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD17571 | DC | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952420531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 KANSALA DR",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214018101",
"telephone_number": "410-573-1884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 VARNUM ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200172145",
"telephone_number": "202-269-7400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATERA",
"first_name": "PAUL",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"name_suffix": "X",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "DC",
"license": "MD17571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.