Kristina Lee Matthews, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00717200 Issued in NJ

Practice address

55 N Gilbert St
Tinton Falls, NJ 07701-4955

Phone

(732) 447-2545

NPI assigned

Sep 12, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 26, 2024 through Mar 26, 2028

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Dr. Shannon Parks D.O. LLC

  • Psychiatry Physician
  • Tinton Falls, NJ
  • NPI 1235935362
  NPD (past)

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1992426514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COLONIAL AVE",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080331505",
            "telephone_number": "908-770-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 N GILBERT ST",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014955",
            "telephone_number": "732-447-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "KRISTINA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00717200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Manner, LPC
• Adil Manzoor, D.O
• Marc Mehlman
• Lance A Markbreiter, M.D.
• Cynthia Massagli, P.T.
• Maximum Care Ambulance Service
• Cameron A. Mazzeo, LCSW, LICSW
• Lourdes Rupac McAlarney, MD
• Melissa McConnell, LIAC
• Heather McGowan, MD

• Physician Assistant in Tinton Falls, NJ
• Providers in Tinton Falls, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.