Individual provider Active NPI

Hayley Mateen, CNP

  • Family Nurse Practitioner
  • Peabody, MA
National Provider Identifier
1982393492
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2303028 Issued in MA
Practice address
1 Roosevelt Ave Ste 204
Peabody, MA 01960-2227
Phone
(978) 762-6262
NPI assigned
May 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2303028 MA Primary

Addresses

Primary practice location

1 Roosevelt Ave Ste 204
Peabody, MA 01960-2227

Mailing address

1 Roosevelt Ave Ste 204
Peabody, MA 01960-2227
Phone (978) 762-6262

Other names 1

  • Hayley McCullough Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230601000254 MA Practitioner - Nurse Practitioner 0840657151 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Danvers Family Doctors, PC CurrentSince May 22, 2023 Accepting new patients

Locations

140 Commonwealth Ave
Ste 202
Danvers, MA 01923
Phone (978) 762-6262

1 Roosevelt Ave
Ste 204
Peabody, MA 01960
Phone (978) 536-7778

Interoperability endpoints

  • Direct secure messaging: hayley.mateen.1@11783.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11783/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1982393492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROOSEVELT AVE STE 204",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602227",
            "telephone_number": "978-762-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROOSEVELT AVE STE 204",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602227",
            "telephone_number": "978-762-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEEN",
        "first_name": "HAYLEY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2303028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAYLEY",
            "last_name": "MCCULLOUGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.