Gulya Matayeva

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

011761 Issued in NY

Practice address

451 Clarkson Ave
Brooklyn, NY 11203-2057

Phone

(718) 245-2005

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: gum9022@direct.nyp.org
• Direct secure messaging: gmatayeva4528097@nychhc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New York Queens Medicine and Surgery, P.C.

  • Pediatrics Physician
  • Fresh Meadows, NY
  • NPI 1003114851
  Medicare reassignment

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1962623439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 AVENUE K APT 3H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032057",
            "telephone_number": "718-245-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAYEVA",
        "first_name": "GULYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5645 Main St",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GUM9022@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "5645 Main St",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5645 Main St",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Valeriy A Matatov, M.D.
• Irina Matatova, FNP
• Roza Matatova
• Yelena Matatova
• Mataybo Medical PLLC
• Mira Matayeva, PHARM.D.
• Maia Matcharashvili
• Neil Robert Mate, D.D.S.
• Wardah Mateen, RPH
• Gabriela Isabel Mateo

• Medical Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.