Individual provider Active NPI

Michael Matasci, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1184759490
Registry record updated Dec 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077450-1 Issued in NY
Practice address
2700 Ocean Ave
Brooklyn, NY 11229-4604
Phone
(917) 836-4499
Fax
(718) 232-9325
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2011

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 077450-1 NY Primary

Addresses

Primary practice location

2700 Ocean Ave
Brooklyn, NY 11229-4604

Mailing address

2078 E 23Rd St
Brooklyn, NY 11229-3644
Phone (718) 256-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121009000556 NY Practitioner - Clinical Social Worker 9739338690 Reassigns benefits to 2 organizations
Practice locations: Brooklyn, NY
I20230907002387 FL Practitioner - Clinical Social Worker 9739338690 Practice locations: Hallandale Beach, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians

Practice addresses (Care Compare)

260 Ave X
Brooklyn, NY 11223-5940
Phone (718) 336-8855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077450-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical & Dental Center Inc CurrentSince Apr 1, 2014 Accepting new patients
Life in Progress Mental Health Counseling PLLC CurrentSince Oct 1, 2021 Accepting new patients
Suny Downstate Medical Center PastSince Apr 1, 2014 Accepting new patients
Federation Employment and Guidance Service, Inc Past Accepting new patients

Locations

770 Flatbush Ave
Brooklyn, NY 11226
Phone (347) 627-3988

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

200 Livingston St
Brooklyn, NY 11201
Phone (718) 522-3399

2615 E 16th St
Fl 2
Brooklyn, NY 11235
Phone (347) 415-7347

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 4

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323561600000",
    "number": "1184759490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2078 E 23RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293644",
            "telephone_number": "718-256-8600",
            "fax_number": "718-232-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294604",
            "telephone_number": "917-836-4499",
            "fax_number": "718-232-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATASCI",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2011-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077450-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.