MICHELLE DOMINGO MATRO (NPI# 1952737116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952737116 |
| Entity Type | Individual |
| Full Name | MICHELLE DOMINGO MATRO |
| Credential | PA-C |
| Practice Address |
1107 Eaton Ave Bethlehem PA 18018-1862 |
| Practice Telephone | 4845262400 |
| Practice Fax Number | 4845263697 |
| Mailing Telephone | 4845262400 |
| Mailing Fax Number | 4845263697 |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2014-05-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA056411 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
016993 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1107 EATON AVE |
| City | BETHLEHEM |
| State | PA |
| Zip Code | 18018-1862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326061581 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1107 Eaton Ave, Bethlehem, PA 18018-1862 | 2006-07-26 |
| 1346855129 | Nathaniel Cunliffe | Social Worker | 1107 Eaton Ave, Bethlehem, PA 18018-1862 | 2020-09-09 |
| 1528687431 | Jillian Sanderson | Social Worker | 1107 Eaton Ave, Bethlehem, PA 18018-1862 | 2020-04-10 |
| 1740823970 | Shawn Aikens | Nurse Practitioner | 1107 Eaton Ave, Bethlehem, PA 18018-1862 | 2019-10-21 |
| 1144863382 | Andrea Grimshaw | Nurse Practitioner | 1107 Eaton Ave, Bethlehem, PA 18018-1862 | 2019-10-21 |
| 1386100485 | Elizabeth Morency | Nurse Practitioner | 1107 Eaton Ave, Bethlehem, PA 18018-1862 | 2019-02-13 |
| 1427513324 | Tracey Smith | Physician Assistant | 1107 Eaton Ave, Bethlehem, PA 18018-1862 | 2019-02-05 |
| 1134698640 | Debora Monserrat | Nurse Practitioner | 1107 Eaton Ave, Bethlehem, PA 18018-1862 | 2018-11-14 |
| 1265909006 | Tina Marsteller | Nurse Practitioner | 1107 Eaton Ave, Bethlehem, PA 18018-1862 | 2018-10-30 |
| 1710462239 | Amy Kathleen Pulcini | Physician Assistant | 1107 Eaton Ave, Bethlehem, PA 18018-1862 | 2018-10-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093373292 | Jade Madison Hennessy | Specialist/Technologist | Moravian College, 1200 Main Street, Bethlehem, PA 18018 | 2019-06-03 |
| 1780106179 | Courtney Jane Kruscavage | Specialist/Technologist | 641 Dellwood Street, Bethlehem, PA 18018 | 2017-07-07 |
| 1205357936 | Balanced Body Therapeutic Massage, LLC | Massage Therapist | 227 W Broad St Ste 102, Bethlehem, PA 18018 | 2017-07-03 |
| 1033567599 | Jessamine Martin | Counselor | 1 East Broad Street, Suite 510, Bethlehem, PA 18018 | 2016-05-25 |
| 1841650041 | Akhi Saha | Internal Medicine | 325 W Broad St Fl 1, Bethlehem, PA 18018 | 2016-03-01 |
| 1063804193 | Paul Minh Le | Internal Medicine | 800 Eaton Ave Ste B, Bethlehem, PA 18018 | 2015-02-26 |
| 1578962841 | Elizabeth Veronica Weiss Iobst | Counselor | 1754 W. Broad St., Bethlehem, PA 18018 | 2014-08-22 |
| 1255771739 | Inner Resources Counseling Inc | Counselor | 807 West Broad St, Bethlehem, PA 18018 | 2013-06-28 |
| 1437404878 | St Luke Hospital | General Acute Care Hospital | 1956 C Allwood Dr., Bethlehem, PA 18018 | 2012-07-23 |
| 1275802944 | St. Luke's Physician Group, Inc | Ophthalmology | 800 Eaton Avenue, Suite 101, Bethlehem, PA 18018 | 2011-12-23 |
| Find all providers in zip 18018 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326441171 | Lauren Peters | Physician Assistant | 1665 Valley Center Pkwy Ste 130, Bethlehem, PA 18017-2352 | 2014-10-07 |
| 1972809283 | Patricia Rowland | Physician Assistant | 2101 Emrick Blvd Ste 100, Bethlehem, PA 18020-8040 | 2011-02-03 |
| 1124072442 | Joanne P Mulligan | Physician Assistant | 74 W Broad St Ste 170, Bethlehem, PA 18018-5738 | 2006-05-20 |
| 1750989745 | Amber Nicole Saylor | Physician Assistant | 801 Ostrum St, Bethlehem, PA 18015-1000 | 2020-10-13 |
| 1780281014 | Ryan Anthony Mathiesen | Physician Assistant | 801 Ostrum St, Bethlehem, PA 18015-1000 | 2020-10-09 |
| 1750850632 | Haley L Mcguigan | Physician Assistant | 801 Ostrum St Ste 2, Bethlehem, PA 18015-1000 | 2018-11-20 |
| 1811465016 | Amber Soden | Physician Assistant | 1469 8th Ave, Bethlehem, PA 18018-2256 | 2018-11-06 |
| 1730655796 | Jordan D Goodwin | Physician Assistant | 801 Ostrum St, Bethlehem, PA 18015-1000 | 2018-10-17 |
| 1598258642 | Amber Fitzpatrick | Physician Assistant | 801 Ostrum St, Bethlehem, PA 18015-1000 | 2018-06-13 |
| 1194238360 | Amy Kester | Physician Assistant | 2545 Schoenersville Rd Fl 2, Bethlehem, PA 18017-7300 | 2017-11-09 |
| Find all providers in BETHLEHEM | ||||
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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.