Individual provider Active NPI

Jarom Matheson, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1710623400
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.024544 Issued in IL
Practice address
2653 W Ogden Ave FL 2
Chicago, IL 60608-1647
Phone
(773) 257-5300
NPI assigned
May 6, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 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 149.024544 IL Primary

Addresses

Primary practice location

2653 W Ogden Ave FL 2
Chicago, IL 60608-1647

Mailing address

2653 W Ogden Ave FL 2
Chicago, IL 60608-1647
Phone (773) 257-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20220620001240 IL Practitioner - Clinical Social Worker 7113306267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mount Sinai Community FoundationGroup PAC ID 5991600405, 247 clinicians

Practice addresses (Care Compare)

2653 W Ogden Ave
FL 3 Suite a
Chicago, IL 60608-1647
Phone (773) 257-6672

Merit-based Incentive Payment System (MIPS)

Final score
94.03 of 100Reported as group
Quality
71.53
Promoting interoperability
100
Improvement activities
40
Cost
76.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.024544ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Matheson Counseling PLLC Clinical Current Accepting new patients
Mount Sinai Community Foundation CurrentSince Jul 1, 2022 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Mount Sinai Community Foundation CurrentSince Jul 1, 2022 Accepting new patients

Locations

2653 W Ogden Ave
Fl 3
Chicago, IL 60608
Phone (773) 257-6701

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

1501 S California Ave
Chicago, IL 60608
Phone (773) 257-6770

1501 S California Ave
#7140
Chicago, IL 60608
Phone (773) 257-4758

2653 W Ogden Ave
Fl 2
Chicago, IL 60608
Phone (773) 257-5300

Organizations & group practices 5

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": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1710623400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2653 W OGDEN AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081647",
            "telephone_number": "773-257-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 W OGDEN AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081647",
            "telephone_number": "773-257-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHESON",
        "first_name": "JAROM",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.