Individual provider Active NPI

Matthew M. Burg, PHD

  • Clinical Psychologist
  • Madison, CT
National Provider Identifier
1508976721
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1422 Issued in CT
Practice address
81 Green Hill Rd
Madison, CT 06443-2161
Phone
(203) 245-1628
Fax
(203) 245-5759
NPI assigned
Aug 30, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1422 CT Primary
Health Service Psychologist 103TH0100X 1422 CT

Addresses

Primary practice location

81 Green Hill Rd
Madison, CT 06443-2161

Mailing address

81 Green Hill Rd
Madison, CT 06443-2161
Phone (203) 245-1628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1422CTMDBehavioral Analyst
001422CTMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1508976721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 GREEN HILL RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432161",
            "telephone_number": "203-245-1628",
            "fax_number": "203-245-5759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 GREEN HILL RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432161",
            "telephone_number": "203-245-1628",
            "fax_number": "203-245-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURG",
        "first_name": "MATTHEW",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "1422",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "CT",
            "license": "1422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.