Itzhak Matusiak, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0650 Issued in WI

Practice address

7161 N Port Washington Rd
Suite 102
Milwaukee, WI 53217-3877

Phone

(414) 352-7682

Fax

(414) 352-7625

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Clinical Psychologist

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Comprehensive Clinical and Consulting Services, Inc

  • Psychologist
  • Milwaukee, WI
  • NPI 1487830790
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200441600000",
    "number": "1033276282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7161 N PORT WASHINGTON RD",
            "address_2": "SUITE 102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532173877",
            "telephone_number": "414-352-7682",
            "fax_number": "414-352-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7161 N PORT WASHINGTON RD",
            "address_2": "SUITE 102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532173877",
            "telephone_number": "414-352-7682",
            "fax_number": "414-352-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUSIAK",
        "first_name": "ITZHAK",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "0650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39007000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth C Mattner, RN, CRNA
• Emily Rose Mattoon, MD
• Britney Mattox
• Lakendra Mynetta Mattox
• Kienna Matus
• Alyssa Rae Matuszak, CPNP-AC
• Michael Edward Matye, DNP
• Michael J Matysik, DPT
• Cory J. Matz, M.D.
• Katherine Therese Matz

• Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.