Individual provider Active NPI

Matthew Philip Siegel, PH.D.

  • Counseling Psychologist
  • Brooklyn, NY
National Provider Identifier
1396074837
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
019172 Issued in NY
Practice address
279 Prospect Park W Apt 1I
Brooklyn, NY 11215-6273
Phone
(917) 439-3141
NPI assigned
Dec 11, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 7771286 ID
Counseling Psychologist 103TC1900X 019172 NY Primary

Addresses

Primary practice location

279 Prospect Park W Apt 1I
Brooklyn, NY 11215-6273

Mailing address

279 Prospect Park W Apt 1I
Brooklyn, NY 11215-6273
Phone (917) 439-3141

Other identifiers 1

IdentifierTypeStateIssuer
A300055086OtherNYMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2017 through Jan 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7771286IDMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1396074837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 PROSPECT PARK W APT 1I",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112156273",
            "telephone_number": "917-439-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 PROSPECT PARK W APT 1I",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112156273",
            "telephone_number": "917-439-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "MATTHEW",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-11",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "ID",
            "license": "7771286",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "019172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A300055086",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.