MRS. AMY MATTIELLI (P.A.-C.) – Surgical Physician Assistant, NPI 1013980606
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,244 PHYSICIAN ASSISTANT in NY
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Provider Addresses for MRS. AMY MATTIELLI (P.A.-C.)
124, Cindy Street, Creighton Village, Brunswick Gardens, Old Bridge, Old Bridge Township, Middlesex County, New Jersey, 08857, United States
OLD BRIDGE, NJ 088573023
Phone: (732) 679-1248
Type: Mailing
2454, Hylan Boulevard, Staten Island, Richmond County, New York, 10306, United States
STATEN ISLAND, NY 10306
Phone: (718) 233-1300
Fax: (718) 980-9728
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-12-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20201204002565 | I | Physician Assistant | NY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 08857)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery, Critical Care (Intensivists) | NY | |
| Diagnostic Radiology | NY | |
| - | NY | |
| Hospitalist, Family Practice | NY | |
| - | NY | |
| Infectious Disease | NC | |
| - | NY | |
| - | NY | |
| Cardiac Surgery, Vascular Surgery | NY | |
| - | CA |
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