Individual provider Active NPI

Matthew Thomas Diner, PHD

  • Clinical Social Worker
  • Fort Myers, FL
National Provider Identifier
1518354984
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085728 Issued in NY
Practice address
9160 Forum Corporate Pkwy Ste 350
Fort Myers, FL 33905-7808
Phone
(833) 872-3825
NPI assigned
Apr 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 108575 TX
Clinical Social Worker 1041C0700X SW19019 FL
Clinical Social Worker 1041C0700X 085728 NY Primary
Clinical Social Worker 1041C0700X SWB-2024-1303 NM
Clinical Social Worker 1041C0700X 6801114968 MI

Addresses

Primary practice location

9160 Forum Corporate Pkwy Ste 350
Fort Myers, FL 33905-7808

Mailing address

9160 Forum Corporate Pkwy Ste 350
Fort Myers, FL 33905-7808
Phone (833) 872-3825

Other names 1

  • Mr. Matthew Thomas Diner Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180507000375 NY Practitioner - Clinical Social Worker 2264796804 Practice locations: Jamaica, NY
I20220201000983 FL Practitioner - Clinical Social Worker 2264796804 Practice locations: Fort Myers, FL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6801114968MIMDClinical Social Worker
SWB-2024-1303NMMDClinical Social Worker
108575TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew T. Diner Clinical CurrentSince Jul 5, 2017 Accepting new patients

Locations

85 5th Ave
Ste 906
New York, NY 10003
Phone (917) 267-8359

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": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1518354984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9160 FORUM CORPORATE PKWY STE 350",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057808",
            "telephone_number": "833-872-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9160 FORUM CORPORATE PKWY STE 350",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057808",
            "telephone_number": "833-872-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINER",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-23",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "108575",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19019",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085728",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2024-1303",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114968",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTHEW",
            "last_name": "DINER",
            "middle_name": "THOMAS",
            "prefix": "MR.",
            "credential": "LCSW, PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.