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

Individual provider Physician Assistant · NPI 1518053719

Kenneth E Mathis, RPA is a Physician Assistant in Waterloo, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2006
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Practice location Address checks out

367 E Main St
Waterloo, NY 13165-1643
Phone: (315) 787-4977
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 003372 (NY)

Record details

NPI number1518053719
Entity typeIndividual (Type 1)
GenderMale
Credentials RPA
Sole proprietorYes
NPI enumeratedOctober 5, 2006
Last updated in NPPESOctober 5, 2007