Matthew Lee Sutera

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

199 Coon Rapids Blvd NW
Suite 306
Coon Rapids, MN 55433-5831

Phone

(763) 780-1520

NPI assigned

Dec 21, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ashlee Secord

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  • NPI 1073902177
  Medicare reassignment NPD
• Ashlee Secord Ma LMFT

  dba Thrive Therapy, LLC

  • Adult Mental Health Clinic/Center
  • Burnsville, MN
  • NPI 1013551803
  NPD
• Family Based Therapy Associates

  • Mental Health Counselor
  • Coon Rapids, MN
  • NPI 1194762005
  NPD (past)
• Family Based Therapy Associates

  • Community/Behavioral Health Agency
  • Chisago City, MN
  • NPI 1891100293
  NPD (past)

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1265897011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 COON RAPIDS BLVD NW",
            "address_2": "SUITE 306",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335831",
            "telephone_number": "763-780-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 COON RAPIDS BLVD NW",
            "address_2": "SUITE 306",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335831",
            "telephone_number": "763-780-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTERA",
        "first_name": "MATTHEW",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Jean Sundquist, DDS
• Cecilia Margaret Manaois Sung, R.N.
• Supervalu Pharmacies Inc (Cub Pharmacy)
• Supervalu Pharmacies Inc (Cub Pharmacy)
• Farheen Surtie
• Kevin G Sutterer, M.A., L.M.F.T.
• Tanya Marie Svenddal, M.A LADC
• Kathryn Marie Svendsen, RN, CNP
• Benjamin D Swanson
• Mandi Sue Swanson, FNP

• Counselor in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.