Individual provider Active NPI

Matthew Reel, LCSW

  • Clinical Social Worker
  • Little Rock, AR
National Provider Identifier
1568718930
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5388-C Issued in AR
Practice address
2100 South Gaines St.
Little Rock, AR 72206
Phone
(501) 681-0412
NPI assigned
Aug 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5388-C AR Primary

Addresses

Primary practice location

2100 South Gaines St.
Little Rock, AR 72206

Mailing address

2100 S Gaines St
Little Rock, AR 72206-1319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220706001287 CA Practitioner - Clinical Social Worker 1153723358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Arkansas College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siyan Clinical CorporationGroup PAC ID 0042470122, 20 clinicians

Practice addresses (Care Compare)

480 Tesconi Cir
Suite B
Santa Rosa, CA 95401-4691
Phone 7072067268109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5388-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Siyan Clinical Corporation CurrentSince Mar 24, 2022 Accepting new patients

Locations

1287 Fulton Rd
Santa Rosa, CA 95401
Phone (707) 543-2031

480 Tesconi Cir
Ste B
Santa Rosa, CA 95401
Phone (707) 206-7268

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": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1568718930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 S GAINES ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722061319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SOUTH GAINES ST.",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72206",
            "telephone_number": "501-681-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEL",
        "first_name": "MATTHEW",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-03",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "5388-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.