ISAAC I MATTA (NPI# 1730157686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730157686 |
| Entity Type | Individual |
| Full Name | ISAAC I MATTA |
| Credential | MD |
| Practice Address |
30 Harrison St Ste 400 Johnson City NY 13790 |
| Mailing Address |
346 Grand Ave Johnson City NY 13790-2580 |
| Practice Telephone | 6077638102 |
| Practice Fax Number | 6077707375 |
| Mailing Telephone | 6077298156 |
| Mailing Fax Number | 6077293982 |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2012-05-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | 111035 | NY | Allopathic & Osteopathic Physicians |
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
111035 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00365233 | 05 |
| Street Address |
30 HARRISON ST STE 400 |
| City | JOHNSON CITY |
| State | NY |
| Zip Code | 13790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932105566 | Roman Thomas Pachulski | Internal Medicine | 30 Harrison St, Suite 250, Johnson City, NY 13790-2161 | 2005-06-28 |
| 1811488455 | Siddharth Dalal | Internal Medicine | 30 Harrison St, Johnson City, NY 13790 | 2018-05-18 |
| 1316342959 | Jodi Villanti | Nurse Practitioner | 30 Harrison St, Suite 460, Johnson City, NY 13790-2161 | 2014-10-24 |
| 1306277017 | Kara Spalik | Nurse Practitioner | 30 Harrison St, Suite 100, Johnson City, NY 13790-2161 | 2013-12-05 |
| 1033459292 | Jerome H Rosenstein Md Pllc | Specialist | 30 Harrison St, Suite 320, Johnson City, NY 13790-2161 | 2013-02-26 |
| 1881946788 | Karen Lee Dunham | Physician Assistant | 30 Harrison St, Suite 455, Johnson City, NY 13790-2161 | 2012-10-03 |
| 1225325921 | Kimberly Hageman Merrill | Nurse Practitioner | 30 Harrison St, Suite 100, Johnson City, NY 13790-2161 | 2011-07-01 |
| 1023252293 | Michail Vitellas | Internal Medicine | 30 Harrison St, Suite 250, Johnson City, NY 13790 | 2009-04-30 |
| 1063659241 | J Richard Cunningham | Surgery | 30 Harrison St, Suite 455, Johnson City, NY 13790-2161 | 2009-01-09 |
| 1821240011 | Shilpa Sambidi | Internal Medicine | 30 Harrison St, Suite 100, Johnson City, NY 13790-2161 | 2008-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578107645 | Thomas William Sorber | Occupational Therapist | 33 Harrison St, Johnson City, Johnson City, NY 13790 | 2019-11-01 |
| 1326534116 | Silver Linings Golden Memory Care | Clinic/Center | 4416 Watson Blvd, Johnson City, NY 13790 | 2018-07-05 |
| 1508308545 | Irene Mukeli Nzasi | Registered Nurse | 156 Corliss Ave Suite 107, Johnson City, NY 13790 | 2016-11-08 |
| 1053867754 | Tabitha Rae Toman | Physical Therapist | 34 Harrison St, Johnson City, NY 13790 | 2016-09-01 |
| 1235685066 | Dianne Brunner | Physical Therapist | 33-55 Harrison Street, Wilson Hospital, Johnson City, NY 13790 | 2016-08-31 |
| 1578982682 | Tracy Lynn Brown | Optometrist | 223 Reynolds Road, Johnson City, NY 13790 | 2014-04-16 |
| 1083041495 | Maryann Serbonich | Pharmacist | 52 Harrison Street, Johnson City, NY 13790 | 2013-09-30 |
| 1134464399 | Kasey Connor Folger | Speech-Language Pathologist | 3 Laurel St., Johnson City, NY 13790 | 2012-11-29 |
| 1467797571 | Bodyworks Physical Therapy LLC | Clinic/Center | 765 Harry L Drive, Johnson City, NY 13790 | 2012-11-29 |
| 1548518400 | Melissa L Korosec | Nurse Practitioner | 30 Harrison St., Suite 250, Johnson City, NY 13790 | 2012-08-27 |
| Find all providers in zip 13790 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427311430 | Gary Linkov | Otolaryngology | 635 Madison Ave # 1402e, New York, NY 10022-1009 | 2012-06-25 |
| 1205196961 | Daniela Maria Burchhardt | Otolaryngology | 89-06 Van Wyck Expy Suite 2t, Jamaica, NY 11418 | 2012-05-29 |
| 1710276753 | Moustafa W. Mourad | Otolaryngology | 115 E 61st St Ste 7c, New York, NY 10065 | 2011-03-30 |
| 1144528050 | Jerrold Conrad Gendler | Otolaryngology | 560 Norhern Blvd, 190, Great Neck, NY 11021 | 2011-03-02 |
| 1447485529 | Paul D. Gittelman,m.d. F.a.c.s. P.l.l.c. | Otolaryngology | 1600 Harrison Ave Ste G-104, Mamaroneck, NY 10543 | 2009-05-19 |
| 1083850044 | Richard W Westreich Md Pllc | Otolaryngology | 4 E 88th St Ste 1b, New York, NY 10128 | 2008-12-22 |
| 1780845545 | Lesley Rabach | Otolaryngology | 33 5th Ave Apt 1b, Lm Medical Nyc, New York, NY 10003-4377 | 2008-06-24 |
| 1033377213 | Joseph J Rousso | Otolaryngology | 440 Northern Blvd, Great Neck, NY 11021-4813 | 2008-05-24 |
| 1528243680 | Stuart Arnold | Otolaryngology | 194 Heron Ln, Manhasset, NY 11030-4012 | 2008-01-08 |
| 1225173370 | Shari Diane Reitzen-bastidas | Otolaryngology | 121 Dekalb Ave # 9e, Brooklyn, NY 11201-5425 | 2007-02-20 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSON CITY |
| Zip Code | 13790 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.