Individual provider Active NPI

Ethan Matone

  • Nephrology Registered Nurse
  • New Hyde Park, NY
National Provider Identifier
1962335653
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology Registered NurseTaxonomy code 163WN0300X
License
91302901 Issued in NY
Practice address
2 Ohio Dr Ste 200
New Hyde Park, NY 11042-1111
Phone
(516) 563-7066
Fax
(516) 563-7067
NPI assigned
Jun 4, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Registered Nurse 163WN0300X 91302901 NY Primary

Addresses

Primary practice location

2 Ohio Dr Ste 200
New Hyde Park, NY 11042-1111

Mailing address

10 Penataquit Dr
Brightwaters, NY 11718-1015
Phone (631) 291-0300

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
91302901NYMDNephrology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1780531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1962335653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PENATAQUIT DR",
            "city": "BRIGHTWATERS",
            "state": "NY",
            "postal_code": "117181015",
            "telephone_number": "631-291-0300",
            "fax_number": "631-291-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OHIO DR STE 200",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421111",
            "telephone_number": "516-563-7066",
            "fax_number": "516-563-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATONE",
        "first_name": "ETHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-04",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nephrology",
            "state": "NY",
            "license": "91302901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.