Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nikki Isis Matus, NURSEPRACTITIONER

Individual provider Primary Care Nurse Practitioner · NPI 1063142529

Nikki Isis Matus, NURSEPRACTITIONER is a Nurse Practitioner in Stony Brook, New York. Qualified in 2020, 6 years ago. Practices with Stony Brook Anaesthesiology University Faculty Practice Corporation, a 87-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2022

Practice location Address checks out

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone: (631) 807-4241
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 310367 (NY)

Record details

NPI number1063142529
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedJune 16, 2022
Last updated in NPPESJune 16, 2022
Certification dateJune 16, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Stony Brook Anaesthesiology University Faculty Practice Corporation — 87 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Stony Brook