Individual provider Active NPI

Matthew James Krieger, LCSW

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1417676958
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
128419 Issued in MA
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

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
110540NYMDSocial Worker
128419MAMDClinical Social Worker
102459NYMDSurgery 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

Verify at the official NPI Registry.