Active NPI
Matthew James Krieger, LCSW
- Clinical Social Worker
- Staten Island, NY
National Provider Identifier
1417676958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 128419
- Practice address
- 138 Targee St
Staten Island, NY 10304-2067 - Phone
- (646) 397-3826
- NPI assigned
- Aug 26, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 128419 | MA | Primary |
| Social Worker | 104100000X | 110540 | NY | |
| Clinical Social Worker | 1041C0700X | 102459 | NY |
Addresses
Primary practice location
138 Targee St
Staten Island, NY 10304-2067
Mailing address
138 Targee St
Staten Island, NY 10304-2067
Phone (646) 397-3826
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260529003580 | NY | Practitioner - Clinical Social Worker | 8527538537 | Practice locations: Staten Island, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Western Michigan Un Homer Stryker School of Med, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
138 Targee St
Staten Island, NY 10304-2067
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110540 | NY | MD | Social Worker |
| 128419 | MA | MD | Clinical Social Worker |
| 102459 | NY | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774310400000",
"number": "1417676958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 TARGEE ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103042067",
"telephone_number": "646-397-3826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 TARGEE ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103042067",
"telephone_number": "646-397-3826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRIEGER",
"first_name": "MATTHEW",
"middle_name": "JAMES",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-26",
"last_updated": "2026-03-24",
"certification_date": "2026-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "128419",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "110540",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "102459",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.