Individual provider Active NPI

Thomas Ernest Di Matteo, ED.D

  • Professional Counselor
  • Clarks Summit, PA
National Provider Identifier
1487914016
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC000273 Issued in PA
Practice address
406 N State St
Clarks Summit, PA 18411-1062
Phone
(570) 342-8434
Fax
(570) 319-5949
NPI assigned
May 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC000273 PA Primary

Addresses

Primary practice location

406 N State St
Clarks Summit, PA 18411-1062

Mailing address

1251 Wyoming Ave
Exeter, PA 18643-1434
Phone (570) 342-8434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240215000075 PA Practitioner - Mental Health Counselor 6507200847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tiffany Griffiths Psy D and Associates IncGroup PAC ID 5496907776, 14 clinicians

Practice addresses (Care Compare)

406 N State St
Clarks Summit, PA 18411-1062
Phone (570) 342-8434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC000273PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Behavioral Health Services, LLC Professional CurrentSince Jul 16, 2023 Accepting new patients
Tiffany Griffiths Psy D & Associates Inc Professional CurrentSince Jan 1, 2024 Accepting new patients
Gabriela M Yurkanin DPM PC PastSince Mar 5, 2023 Accepting new patients

Locations

406 N State St
Clarks Summit, PA 18411
Phone (570) 342-8434

502 N Blakely St
Dunmore, PA 18512
Phone (570) 342-8434

1251 Wyoming Ave
Exeter, PA 18643
Phone (570) 307-9054

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18643/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1487914016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 WYOMING AVE",
            "city": "EXETER",
            "state": "PA",
            "postal_code": "186431434",
            "telephone_number": "570-342-8434",
            "fax_number": "570-299-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N STATE ST",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111062",
            "telephone_number": "570-342-8434",
            "fax_number": "570-319-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI MATTEO",
        "first_name": "THOMAS",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "ED.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-16",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC000273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Summit, PA

Sources for this page

Verify at the official NPI Registry.