Individual provider Active NPI

Matthew J McKay, MSW, LICSW

  • Clinical Social Worker
  • Rochester, MN
National Provider Identifier
1073765111
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13210 Issued in MN
Practice address
1110 6TH St NW
Rochester, MN 55901-1839
Phone
(507) 287-2010
Fax
(507) 287-7805
NPI assigned
Oct 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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 13210 MN Primary

Addresses

Primary practice location

1110 6TH St NW
Rochester, MN 55901-1839

Mailing address

1110 6TH St NW
Rochester, MN 55901-1839
Phone (507) 287-2010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20180307002108 MN Practitioner - Clinical Social Worker 3476814401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Zumbro Valley Health CenterGroup PAC ID 7810961703, 24 clinicians

Practice addresses (Care Compare)

343 Wood Lake Dr SE
Rochester, MN 55904-6242
Phone (507) 289-2089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13210MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Zumbro Valley Health Center CurrentSince Dec 11, 2023 Accepting new patients
Family Service Rochester Past Accepting new patients

Locations

343 Woodlake Dr SE
Rochester, MN 55904
Phone (507) 289-2089

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/familyservicerochester/r4/

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": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1073765111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 6TH ST NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011839",
            "telephone_number": "507-287-2010",
            "fax_number": "507-287-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 6TH ST NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011839",
            "telephone_number": "507-287-2010",
            "fax_number": "507-287-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAY",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.