Individual provider Active NPI

Kelly Matthews-Pluta, L.C.S.W.

  • Clinical Social Worker
  • Wilmette, IL
National Provider Identifier
1396754982
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149008010 Issued in IL
Practice address
3545 Lake Ave
Suite 200
Wilmette, IL 60091-1058
Phone
(847) 251-7350
Fax
(847) 853-2600
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 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 149008010 IL Primary

Addresses

Primary practice location

3545 Lake Ave
Suite 200
Wilmette, IL 60091-1058

Mailing address

124 Woodland Ave
Winnetka, IL 60093-4241
Phone (847) 441-0117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20081008000355 IL Practitioner - Clinical Social Worker 8729156427 Practice locations: Evanston, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

820 Davis St
Suite 504
Evanston, IL 60201-4448
Phone (847) 512-8632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thurston & Associates Past Accepting new patients
Family Service Center of Wilmette Glenview Northbrook Kenilworth Clinical PastSince Nov 15, 2011 Accepting new patients

Organizations & group practices 2

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1396754982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 WOODLAND AVE",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600934241",
            "telephone_number": "847-441-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 LAKE AVE",
            "address_2": "SUITE 200",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911058",
            "telephone_number": "847-251-7350",
            "fax_number": "847-853-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS-PLUTA",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149008010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

Verify at the official NPI Registry.