Active NPI
Matthew J. Roman, LICSW
- Clinical Social Worker
- Providence, RI
National Provider Identifier
1144234246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW01349
- Practice address
- 55 Hope St
C/O Family Service of Rhode Island
Providence, RI 02906-2001 - Phone
- (401) 331-1350
- Fax
- (401) 277-3366
- NPI assigned
- Jul 27, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW01349 | RI | Primary |
Addresses
Primary practice location
55 Hope St
C/O Family Service of Rhode Island
Providence, RI 02906-2001
Mailing address
223 Prosser TRL
Charlestown, RI 02813-2840
Phone (401) 331-1350
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 408143 | Other | RI | BLUE CHIP |
| NHP | Other | 1021740 GROUP | |
| 30315-8 | Other | RI | BLUE CROSS/SHIELD |
| UBH | Other | 6232362 | |
| 478002 | Other | VALUE OPTIONS | |
| MR33981 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144234246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 PROSSER TRL",
"city": "CHARLESTOWN",
"state": "RI",
"postal_code": "028132840",
"telephone_number": "401-331-1350",
"fax_number": "401-277-3366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 HOPE ST",
"address_2": "C/O FAMILY SERVICE OF RHODE ISLAND",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029062001",
"telephone_number": "401-331-1350",
"fax_number": "401-277-3366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMAN",
"first_name": "MATTHEW",
"middle_name": "J.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW01349",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "408143",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1021740 GROUP",
"identifier": "NHP",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/SHIELD",
"identifier": "30315-8",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "6232362",
"identifier": "UBH",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "478002",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MR33981",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.