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Export Provider Record NPI 1124555206
Matthew S UjevichDO
Active
NPI Number1124555206
NPI TypeNPI-1 Individual
SpecialtyFamily Medicine
Provider Details
NPI1124555206
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2017-05-19
Last Updated2023-09-21
Mailing Address120 Chambers Dr
Monaca, PA 15061-1349
United States
Phone: (724) 630-8384
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Primary Practice Address1780 Hanshaw Rd
Ithaca, NY 14850-9105
United States
Phone: (607) 257-5858
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No207Q00000X – Family MedicinePAOS020535
Yes207Q00000X – Family MedicineNY324113
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About NPI 1124555206

Matthew S Ujevich DO is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1124555206. The primary specialty listed is Family Medicine. The provider is located in Ithaca, NY. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2017-05-19. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1124555206?

NPI 1124555206 belongs to Matthew S Ujevich DO, a Family Medicine in Ithaca, NY. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1124555206 active?

The current status of NPI 1124555206 in the NPPES registry is Active. The record was last updated on 2023-09-21.

What specialty is NPI 1124555206?

NPI 1124555206 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1124555206?

You can verify NPI 1124555206 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1124555206?

The primary practice address on file for NPI 1124555206 is 1780 Hanshaw Rd, Ithaca, NY 14850-9105. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1124555206 issued?

NPI 1124555206 was first issued (enumerated) on 2017-05-19. The NPPES record was last updated on 2023-09-21.

Practice Location Map

Matthew S Ujevich is located at 1780 Hanshaw Rd, Ithaca, NY. Use the map below to find directions or verify the practice location.

📍 1780 Hanshaw Rd, Ithaca, NY 14850-9105  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Matthew S Ujevich. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1124555206. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Family MedicineOS020535PA
Family Medicine324113NY
Data Verified from CMS NPPES Last synced: 2026-06-30 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162