Matthew John Conetta, PSY.D., L.P.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP6658 Issued in MN

Practice address

1400 Madison Ave Ste 352
Mankato, MN 56001-4458

Phone

(507) 625-1811

Fax

(507) 387-7785

NPI assigned

Mar 16, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mankato Clinic LTDGroup PAC ID 5597677955, 243 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthewconetta@mklt.allscriptsdirect.net

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.

• Mankato Clinic LTD

  • Family Medicine Physician
  • Mankato, MN
  • NPI 1629044029
  Medicare reassignment Care Compare group NPD
• Open Door Health Center

  • Federally Qualified Health Center (FQHC)
  • Mankato, MN
  • NPI 1891740908
  Medicare reassignment NPD
• Open Door Health Center

  • Federally Qualified Health Center (FQHC)
  • Shakopee, MN
  • NPI 1114446283
  NPD

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1083299531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8674",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560028674",
            "telephone_number": "507-389-8507",
            "fax_number": "507-625-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE STE 352",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014458",
            "telephone_number": "507-625-1811",
            "fax_number": "507-387-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONETTA",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "credential": "PSY.D., L.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-16",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "messagec@direct.schrc.com",
            "affiliation": "N",
            "address_1": "610 Florence Ave",
            "city": "Owatonna",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550604704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Coleman, NP
• Meghan M Coleman, D.C.
• Kaitlyn Collins
• Meghan Bouquet Collins, DPT
• Comfor at Home Care Service LLC
• Sabrina Marie Conlin
• Jennifer Lynn Connor, LICSW
• James Daniel Connors, DDS
• Jamie Kay Conrath, DNP-PMHNP-BC
• Seth Consoer, M.D.

• Clinical Psychologist in Mankato, MN
• Providers in Mankato, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.