1. Home
  2. Directory
  3. New York
  4. Great Neck
  5. Specialist
  6. NPI Profile

DR. KENNETH F MATTUCCI M.D.
NPI 1013957059
Specialist in Great Neck, NY

Active since June 07, 2006Opted out of Medicare · through Sep 12, 2027
29 BARSTOW RD, SUITE 203, GREAT NECK, NY 11021(516) 482-7960(516) 482-4122 Get Directions Write a Review

NPPES record last updated: November 25, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kenneth F Mattucci M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENNETH F MATTUCCI M.D. (NPI 1013957059) is an individual specialist in Great Neck, New York, licensed in New York (096685) and active in the NPI registry since June 2006. He has opted out of Medicare through September 12, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1013957059
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. KENNETH F MATTUCCICredential: M.D.
Location Address29 BARSTOW RD, SUITE 203Great Neck, NY 11021-2209
Mailing Address11 Nome DrWoodbury, NY 11797-3404 · (516) 367-4281 · Fax (516) 367-3134
Phone(516) 482-7960
Fax(516) 482-4122
Sole ProprietorYes
Enumeration DateJune 7, 2006
Last NPPES UpdateNovember 25, 2008
✔ NPI 1013957059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 096685
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
29 BARSTOW RD, Great Neck, NY 11021
Open in Google Maps ↗

Other Identifiers 2

Medicare UPINB19998NY
Medicare ID-Type Unspecified09080111NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kenneth F Mattucci M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 12, 2023 through September 12, 2027.

Opt-Out Effective DateSeptember 12, 2023
Opt-Out In Effect ThroughSeptember 12, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SUSAN COVEN D.D.S.
Dentist (Periodontics)
29 BARSTOW RD, 105
GREAT NECK, NY 11021
Nassau County (516) 466-3611
ANDRES E HUBERMAN MD
Psychiatry & Neurology (Addiction Psychiatry)
29 BARSTOW RD
GREAT NECK, NY 11021
Nassau County (917) 628-4449
DAVID KAMINSKY M.D.
Psychiatry & Neurology (Sleep Medicine)
29 BARSTOW RD
GREAT NECK, NY 11021
Nassau County (516) 487-4171
MS. FUKU EVANGELINE FOSTER LCSW
Social Worker (Clinical)
29 BARSTOW RD
GREAT NECK, NY 11021
Nassau County (917) 526-0766
RONALD A LEVY MD PC
Specialist
29 BARSTOW RD, SUITE 203
GREAT NECK, NY 11021
Nassau County (516) 482-7965
MS. PAMELA SILLER MD
Psychiatry & Neurology (Psychiatry)
29 BARSTOW RD, SUITE 304
GREAT NECK, NY 11021
Nassau County (917) 841-0663
MRS. BARBARA ANN BERKOWITZ LCSW
Social Worker (Clinical)
29 BARSTOW RD
GREAT NECK, NY 11021
Nassau County (516) 759-7732
MS. DIANE R CAPEZZA L.C.S.W.
Social Worker (Clinical)
29 BARSTOW RD, SUITE 205
GREAT NECK, NY 11021
Nassau County (718) 279-7198

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Mattucci's NPI number?

The NPI number for Kenneth Mattucci is 1013957059. It was assigned to this individual provider in the NPPES registry on June 7, 2006.

Where is Kenneth Mattucci located?

Kenneth Mattucci practices at 29 Barstow Rd Suite 203, Great Neck, NY 11021. The listed phone number is (516) 482-7960.

What is Kenneth Mattucci's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Kenneth Mattucci enrolled in Medicare?

No. Kenneth Mattucci has opted out of Medicare through September 12, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kenneth Mattucci was last updated on November 25, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.