Matthew Ellam, CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2295977 Issued in MA

Practice address

1330 Beacon St Ste 202
Brookline, MA 02446-3202

Phone

(617) 354-4450

NPI assigned

Feb 19, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: colonycarebehavioralhealth.matthewellam@156401.advancedmd-direct.com
• Direct secure messaging: mellam284523@direct.ochin.org

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.

• Elemental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
  • NPI 1154271328
  NPD Authorized official
• Colony Care Inc

  dba Colony Care Behavioral Health

  • Mental Health Counselor
  • Wellesley, MA
  • NPI 1720053408
  NPD

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

{
    "created_epoch": "1424304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1083006696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LIBERTY SQ # 96730",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021095800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BEACON ST STE 202",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463202",
            "telephone_number": "617-354-4450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Liberty Sq # 96730",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021095800",
            "country_code": "US",
            "telephone_number": "617-286-6764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLAM",
        "first_name": "MATTHEW",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-19",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2295977",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2295977",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Dental, Inc.
• Elizabeth Apkin PSYD LLC (Elizabeth Apkin PsyD)
• Elizabeth Childs M.D., P.C.
• Amar Salah Elkhalifa, MD
• Ella Podhurst Nutrition LLC
• Nicole Ellerbe
• Virginia Elliott, M.A., M.ED.
• Sharone Ely, PA-C
• Elysium Counseling LLC
• Patrice M Emberley, NP

• Psychiatric/Mental Health Nurse Practitioner in Brookline, MA
• Providers in Brookline, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.