Individual provider Active NPI

Matthew David Pentkowski, LAADC

  • Addiction (Substance Use Disorder) Counselor
  • Newport Beach, CA
National Provider Identifier
1184414534
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
336 Canal St
Newport Beach, CA 92663-1802
Phone
(949) 698-8531
NPI assigned
May 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LR10290623 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

336 Canal St
Newport Beach, CA 92663-1802

Mailing address

336 Canal St
Newport Beach, CA 92663-1802
Phone (949) 698-8531

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
LR10290623CAMDCounselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1184414534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 CANAL ST",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926631802",
            "telephone_number": "949-698-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 CANAL ST",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926631802",
            "telephone_number": "949-698-8531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTKOWSKI",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "LAADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "LR10290623",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.