Individual provider Active NPI

Maureen Matengo

  • Registered Nurse
  • Allentown, PA
National Provider Identifier
1992236178
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
TLRN049525 Issued in PA
Practice address
4949 Liberty LN
Suite 210
Allentown, PA 18106-9014
Phone
(484) 560-6600
NPI assigned
Mar 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X TLRN049525 PA Primary

Addresses

Primary practice location

4949 Liberty LN
Suite 210
Allentown, PA 18106-9014

Mailing address

4949 Liberty LN
Suite 210
Allentown, PA 18106-9014

Other identifiers 1

IdentifierTypeStateIssuer
102888687MedicaidPA

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
TLRN049525PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Nursing Associates LLC Current Accepting new patients

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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1992236178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 LIBERTY LN",
            "address_2": "SUITE 210",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 LIBERTY LN",
            "address_2": "SUITE 210",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069014",
            "telephone_number": "484-560-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATENGO",
        "first_name": "MAUREEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "TLRN049525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102888687",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.