MATRIX MEDICAL OF NEW YORK PC
NPI 1639433063
Nurse Practitioner in New York, NY
About Matrix Medical Of New York Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MATRIX MEDICAL OF NEW YORK PC (NPI 1639433063) is a healthcare organization registered as a nurse practitioner in New York, New York and active in the NPI registry since June 2012. The organization lists Stephanie Peterson, Manager Credentialing, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Matrix Medical Of New York Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
113Medicare enrollment records show 113 clinicians reassign Medicare billing to Matrix Medical Of New York PC, which bills Medicare for the services they deliver. Of these, 27 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Nearest to this location (20)
See all 113Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Matrix Medical Of New York PC's NPI number?
The NPI number for Matrix Medical Of New York PC is 1639433063. It was assigned to this organization in the NPPES registry on June 29, 2012.
Where is Matrix Medical Of New York PC located?
Matrix Medical Of New York PC is located at 1740 Broadway, New York, NY 10019. The listed phone number is (480) 862-1677.
What is Matrix Medical Of New York PC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Matrix Medical Of New York PC enrolled in Medicare?
Yes. Matrix Medical Of New York PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Matrix Medical Of New York PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 113 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Matrix Medical Of New York PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 27 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Matrix Medical Of New York PC was last updated on October 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.
# Matrix Medical Of New York Pc · NPI 1639433063
Nurse Practitioner organization in New York, New York. Organization record, active in the CMS NPPES registry since June 29, 2012.
## Identity
- **NPI:** 1639433063 (Entity type: Organization)
- **Enumerated:** June 29, 2012
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **Organization subpart:** No
- **Authorized official:** Stephanie Peterson, MANAGER CREDENTIALING
## Practice location
- **Address:** 1740 BROADWAY, New York, NY 10019-4315
- **Phone:** (480) 862-1677 · **Fax:** (480) 718-7643
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 113 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 27 practice within 10 miles; [full list](https://npiprofile.com/npi/1639433063/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 9, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1639433063) · Data from the CMS NPPES public registry.