Individual provider Active NPI

Amy Matheson, PSY.D.

  • Psychologist
  • Tacoma, WA
National Provider Identifier
1609935089
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY00002980 Issued in WA
Practice address
1608 S J St FL 2
Tacoma, WA 98405-4930
Phone
(253) 274-7503
Fax
(253) 274-7993
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY00002980 WA Primary

Addresses

Primary practice location

1608 S J St FL 2
Tacoma, WA 98405-4930

Mailing address

1608 S J St FL 2
Tacoma, WA 98405-4930
Phone (253) 274-7503

Other practice location 1

3580 Pacific Ave
Tacoma, WA 98418-7915
Phone (253) 798-4500

Other identifiers 1

IdentifierTypeStateIssuer
2167684MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amatheson653461@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20070917000751 WA Practitioner - Clinical Psychologist 4284728569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1608 S J St
FL 2
Tacoma, WA 98405-4930
Phone (253) 274-7503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY00002980WAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Jan 11, 2021 Accepting new patients
Franciscan Medical Group CurrentSince Jan 11, 2021 Accepting new patients
Franciscan Medical Group Current Accepting new patients

Locations

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 3

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1609935089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 S J ST FL 2",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054930",
            "telephone_number": "253-274-7503",
            "fax_number": "253-274-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 S J ST FL 2",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054930",
            "telephone_number": "253-274-7503",
            "fax_number": "253-274-7993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3580 Pacific Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984187915",
            "country_code": "US",
            "telephone_number": "253-798-4500",
            "fax_number": "253-798-4493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHESON",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2021-01-20",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00002980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2167684",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amatheson653461@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1608 S J St Fl 2",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.