Individual provider Active NPI

Matthew Francis Wilson, LCSW

  • Clinical Social Worker
  • Pittsburgh, PA
National Provider Identifier
1003472853
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW020460 Issued in PA
Practice address
417 Gettysburg St Ste 200
Pittsburgh, PA 15206-4529
Phone
(412) 712-2863
NPI assigned
May 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW020460 PA Primary

Addresses

Primary practice location

417 Gettysburg St Ste 200
Pittsburgh, PA 15206-4529

Mailing address

850 Heberton St
Pittsburgh, PA 15206-2263
Phone (412) 712-2863

Other practice location 1

412 E Commons
Pittsburgh, PA 15212-5310
Phone (412) 323-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190612000629 PA Practitioner - Clinical Social Worker 7214260991 Practice locations: Pittsburgh, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

907 W St
RM 213
Pittsburgh, PA 15221-2838
Phone (412) 254-4130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Life Center Corporation CurrentSince Apr 17, 2019 Accepting new patients
Mercy Life Center Corp CurrentSince Apr 17, 2019 Accepting new patients

Locations

412 E Commons
Pittsburgh, PA 15212
Phone (412) 323-4500

1200 Reedsdale St
Pittsburgh, PA 15233
Phone (412) 323-4543

Organizations & group practices 2

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": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1003472853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HEBERTON ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152062263",
            "telephone_number": "412-712-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 GETTYSBURG ST STE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152064529",
            "telephone_number": "412-712-2863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 E Commons",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152125310",
            "country_code": "US",
            "telephone_number": "412-323-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MATTHEW",
        "middle_name": "FRANCIS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-17",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.