Individual provider Active NPI

Jean Matus

  • Critical Care Medicine Registered Nurse
  • Great Falls, MT
National Provider Identifier
1962298869
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
NURRNLIC102657 Issued in MT
Practice address
1208 Park Garden Rd
Great Falls, MT 59404-3628
Phone
(406) 403-9728
NPI assigned
Apr 17, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X NURRNLIC102657 MT Primary

Addresses

Primary practice location

1208 Park Garden Rd
Great Falls, MT 59404-3628

Mailing address

1208 Park Garden Rd
Great Falls, MT 59404-3628
Phone (406) 403-9728

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

State licenses

LicenseStateTypeSpecialty
NURRNLIC102657MTMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1962298869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 PARK GARDEN RD",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594043628",
            "telephone_number": "406-403-9728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 PARK GARDEN RD",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594043628",
            "telephone_number": "406-403-9728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUS",
        "first_name": "JEAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MT",
            "license": "NURRNLIC102657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.