Individual provider Active NPI

Matthew Thomas Somerville, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Enfield, CT
National Provider Identifier
1508442328
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
84465 Issued in CT
Practice address
170 Hazard Ave FL 1
Enfield, CT 06082-4520
Phone
(860) 763-3296
Fax
(860) 763-4580
NPI assigned
Mar 22, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 84465 CT
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0402X 84465 CT Primary

Addresses

Primary practice location

170 Hazard Ave FL 1
Enfield, CT 06082-4520

Mailing address

170 Hazard Ave FL 1
Enfield, CT 06082-4520
Phone (860) 763-3296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210526001931 NC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 5193124014

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CT Neurology, PC Neurology With Special Qualifications in Child Neurology Past Accepting new patients

Organizations & group practices 1

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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1508442328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 HAZARD AVE FL 1",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824520",
            "telephone_number": "860-763-3296",
            "fax_number": "860-763-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 HAZARD AVE FL 1",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824520",
            "telephone_number": "860-763-3296",
            "fax_number": "860-763-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMERVILLE",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "84465",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CT",
            "license": "84465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.