Individual provider Active NPI

Matthew Ewen

  • Clinical Social Worker
  • Cambridge, MA
National Provider Identifier
1104234897
Registry record updated Jul 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1493 Cambridge St
Cambridge, MA 02139-1047
Phone
(617) 665-1185
NPI assigned
Jul 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2014

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 Primary

Addresses

Primary practice location

1493 Cambridge St
Cambridge, MA 02139-1047

Mailing address

1493 Cambridge St
Cambridge, MA 02139-1047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20180530000489 MA Practitioner - Clinical Social Worker 1658636329 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Apr 14, 2018 Accepting new patients
Cambridge Public Health Commission CurrentSince Apr 14, 2018 Accepting new patients

Locations

1493 Cambridge St
Bsmt
Cambridge, MA 02139

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583

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": "1406332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406332800000",
    "number": "1104234897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047",
            "telephone_number": "617-665-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWEN",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-26",
        "last_updated": "2014-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.