Active NPI
Elka Matusof
- School Psychologist
- Brooklyn, NY
National Provider Identifier
1588972897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 2183005
- Practice address
- 470 Lefferts Ave
Brooklyn, NY 11225-4407 - Phone
- (718) 735-0770
- Fax
- (718) 804-8930
- NPI assigned
- Sep 21, 2010
- Last updated
- Sep 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 2183005 | NY | Primary |
Addresses
Primary practice location
470 Lefferts Ave
Brooklyn, NY 11225-4407
Mailing address
1505 President St
Brooklyn, NY 11213-4542
Phone (347) 415-4971
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2183005 | NY | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crown Multieducational Services | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Case Management Agency
- Brooklyn, NY
- NPI 1164739645
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285027200000",
"number": "1588972897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 PRESIDENT ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112134542",
"telephone_number": "347-415-4971",
"fax_number": "718-756-2059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 LEFFERTS AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112254407",
"telephone_number": "718-735-0770",
"fax_number": "718-804-8930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATUSOF",
"first_name": "ELKA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-21",
"last_updated": "2010-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "2183005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.