Kenneth Mathis, R.P.A.
NPI 1518053719 · Physician Assistant · Waterloo, NY
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kenneth Mathis, R.P.A. is a Physician Assistant provider in Waterloo, NY (NPI 1518053719).
Provider details
- NPI number
- 1518053719
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- R.P.A.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 003372 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-10-05
- Last updated
- 2007-10-05
Frequently asked questions
- What is Kenneth Mathis's NPI number?
- Kenneth Mathis's National Provider Identifier (NPI) is 1518053719, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kenneth Mathis's specialty?
- Kenneth Mathis is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Kenneth Mathis located?
- Kenneth Mathis's practice location on file with NPPES is 367 E Main St, Waterloo, NY 13165-1643.
- What is Kenneth Mathis's phone number?
- The practice phone number listed in the NPPES registry for Kenneth Mathis is (315) 787-4977.
- Does Kenneth Mathis accept Medicare?
- Kenneth Mathis is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kenneth Mathis's NPI active?
- Yes — Kenneth Mathis's NPI (1518053719) is active in the NPPES registry as of the last update on 2007-10-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.