Active NPI
Matthew Desrosiers, LCSW
- Clinical Social Worker
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW.09929397
- Practice address
- 32 Broadway
Suite 200
New York, NY 10004-1609 - Phone
- (212) 951-6866
- NPI assigned
- Sep 17, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW.09929397 | CO | Primary |
| Clinical Social Worker | 1041C0700X | 090921 | NY |
Addresses
Primary practice location
32 Broadway
Suite 200
New York, NY 10004-1609
Mailing address
PO Box 110429
Aurora, CO 80042-0429
Other practice location 1
1890 N Revere Ct
Aurora, CO 80045-7464
Phone (720) 848-0000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1890 N Revere CT
Helen and Arthur E Johnson Cu Depression Ce
Aurora, CO 80045-2570
Phone (303) 724-3300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW.09929397 | CO | MD | Clinical Social Worker |
| 090921 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physicians, Incorporated | Current | Accepting new patients | |
| University Physicians Incorporated | Current | Accepting new patients | |
| University Physicians, Incorporated | Current | Accepting new patients |
Locations
1890 N Revere Ct
Aurora, CO 80045
Phone (303) 724-1000
1890 N Revere Ct
Ste 4020
Aurora, CO 80045
Phone (303) 724-1000
12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006
13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846
Dept 1061
Denver, CO 80256
Organizations & group practices 3
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.
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- Sports Medicine (Orthopaedic Surgery) Physician
- Denver, CO
- NPI 1275045049
-
- Oral & Maxillofacial Surgery (D.M.D.)
- Aurora, CO
- NPI 1467801738
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691625600000",
"number": "1104295344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 110429",
"city": "AURORA",
"state": "CO",
"postal_code": "800420429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 BROADWAY",
"address_2": "SUITE 200",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100041609",
"telephone_number": "212-951-6866"
}
],
"practiceLocations": [
{
"address_1": "1890 N Revere Ct",
"address_purpose": "LOCATION",
"city": "Aurora",
"state": "CO",
"postal_code": "800457464",
"country_code": "US",
"telephone_number": "720-848-0000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DESROSIERS",
"first_name": "MATTHEW",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-17",
"last_updated": "2023-08-10",
"certification_date": "2023-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "CSW.09929397",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "090921",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.