NPIMap

Individual provider Active NPI

Matthew N Eggen, MSW

  • Clinical Social Worker
  • Jamaica Plain, MA
National Provider Identifier
1154608982
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
214539 Issued in MA
Practice address
157 Green St
Jamaica Plain, MA 02130-2667
Phone
(443) 813-2108
NPI assigned
Nov 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 214539 MA Primary
Clinical Social Worker 1041C0700X 16564 MD

Addresses

Primary practice location

157 Green St
Jamaica Plain, MA 02130-2667

Mailing address

531 Constant Ridge CT
Abingdon, MD 21009-1669
Phone (443) 813-2108

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
214539MAMDClinical Social Worker
16564MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
KNM Enterprises LLC Clinical Current Accepting new patients

Organizations & group practices 1

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": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1154608982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 CONSTANT RIDGE CT",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210091669",
            "telephone_number": "443-813-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 GREEN ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302667",
            "telephone_number": "443-813-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGEN",
        "first_name": "MATTHEW",
        "middle_name": "N",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "214539",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "16564",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.