Individual provider Active NPI

Joshua Matyi, PH.D.

  • Clinical Neuropsychologist
  • Omaha, NE
National Provider Identifier
1093407223
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1121 Issued in NE
Practice address
4242 Farnam St
Omaha, NE 68131-2806
Phone
(402) 552-6094
Fax
(402) 552-7701
NPI assigned
May 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1121 NE
Health Service Psychologist 103TH0100X 1121 NE
Clinical Neuropsychologist 103G00000X 1121 NE Primary

Addresses

Primary practice location

4242 Farnam St
Omaha, NE 68131-2806

Mailing address

988425 Nebraska Medical Ctr
Omaha, NE 68198-8425
Phone (402) 552-6094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20230926004128 KS Practitioner - Clinical Psychologist 1951755859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8533 E 32ND St N
Wichita, KS 67226-2611
Phone (316) 293-2622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
03237KSMDMental Health Counselor
1121NEMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince May 28, 2023 Accepting new patients
University of Kansas School of Medicine Wichita Medical Practice Assoc CurrentSince Sep 18, 2023 Accepting new patients

Locations

1010 N Kansas St
Ste 3054
Wichita, KS 67214
Phone (316) 293-2647

1010 N Kansas St
Wichita, KS 67214
Phone (316) 293-2622

8533 E 32nd St N
Wichita, KS 67226
Phone (316) 293-2622

4242 Farnam St
Omaha, NE 68131
Phone (402) 552-6094

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": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1093407223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988425 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988425",
            "telephone_number": "402-552-6094",
            "fax_number": "402-552-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 FARNAM ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312806",
            "telephone_number": "402-552-6094",
            "fax_number": "402-552-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATYI",
        "first_name": "JOSHUA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NE",
            "license": "1121",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "NE",
            "license": "1121",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NE",
            "license": "1121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.