Individual provider Active NPI

Matthew Metzger, PH.D.

  • Clinical Psychologist
  • Los Gatos, CA
National Provider Identifier
1003048968
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY25425 Issued in CA
Practice address
475 Alberto Way Ste 180
Los Gatos, CA 95032-5481
Phone
(970) 236-6240
Fax
(408) 550-1879
NPI assigned
Aug 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY25425 CA Primary

Addresses

Primary practice location

475 Alberto Way Ste 180
Los Gatos, CA 95032-5481

Mailing address

475 Alberto Way Ste 180
Los Gatos, CA 95032-5481
Phone (970) 236-6240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150108000604 CA Practitioner - Clinical Psychologist 6103047709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspring Psychology PCGroup PAC ID 4385948041, 5 clinicians

Practice addresses (Care Compare)

475 Alberto Way
Suite 180
Los Gatos, CA 95032-5481
Phone (408) 357-4102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY25425CAMDClinical Psychologist
25425CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspring Psychology PC Clinical CurrentSince Jan 1, 2016 Accepting new patients

Locations

409 Alberto Way
Ste 5
Los Gatos, CA 95032
Phone (408) 357-4102

475 Alberto Way
Ste 180
Los Gatos, CA 95032
Phone (408) 357-4102

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1003048968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 ALBERTO WAY STE 180",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950325481",
            "telephone_number": "970-236-6240",
            "fax_number": "408-550-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 ALBERTO WAY STE 180",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950325481",
            "telephone_number": "970-236-6240",
            "fax_number": "408-550-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZGER",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-11",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.