Active NPI
Matthew Kelly
- Mental Health Counselor
- Oswego, NY
National Provider Identifier
1033588678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 335 W 1St St
Oswego, NY 13126-3689 - Phone
- (315) 343-3344
- NPI assigned
- Sep 24, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
335 W 1St St
Oswego, NY 13126-3689
Mailing address
335 W 1St St
Oswego, NY 13126-3689
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7266 Buckley Rd
N Syracuse, NY 13212-2649
Phone (315) 458-0919
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bright Path Center, Inc. | Mental Health | Current | Accepting new patients |
| Shine Medical Providers PC | Past | Accepting new patients | |
| Delconte Counseling LCSW PC | Mental Health | Past | Accepting new patients |
| Shine Medical PC | Past | Accepting new patients |
Locations
7266 Buckley Rd
Syracuse, NY 13212
Phone (315) 458-0919
Organizations & group practices 4
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- N Syracuse, NY
- NPI 1427810787
-
- Psychiatry Physician
- New York, NY
- NPI 1427783950
-
- Psychiatry Physician
- Philadelphia, PA
- NPI 1538894050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443052800000",
"number": "1033588678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "335 W 1ST ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131263689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 W 1ST ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131263689",
"telephone_number": "315-343-3344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MATTHEW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-24",
"last_updated": "2015-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oswego, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; 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.