Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kenneth Ryan Mataragas, PA-C

Individual provider Physician Assistant · NPI 1003326133

Kenneth Ryan Mataragas, PA-C is a Physician Assistant in Port Jefferson Station, New York. Qualified in 2017, 9 years ago. Practices with Optum Medical Care PC, a 1,018-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
9
In the registry since
2017
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1500 NY-112 Bldg 6 Ste C
Port Jefferson Station, NY 11776
Phone: (631) 732-9090
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1003326133
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 3, 2017
Last updated in NPPESJanuary 17, 2024
Certification dateJanuary 14, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Optum Medical Care Pc — 1018 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Port Jefferson Station