Matthew J Ditty, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3658 Issued in OR

Practice address

305 NE E St Ste 200B
Grants Pass, OR 97526-2163

Phone

(541) 226-4396

NPI assigned

Dec 12, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Southern Oregon Psychological Services LLC

  • Psychologist
  • Grants Pass, OR
  • NPI 1245946110

  Mental Health

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1760750319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NE E ST STE 200B",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262163",
            "telephone_number": "541-226-4396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 NE E ST STE 200B",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262163",
            "telephone_number": "541-226-4396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTY",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-12",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desy P Wilson DDS Ms PC
• Carolyn I Diaz
• James Thomas Dibb, DO
• Russell King Dillon, PT
• Roxanna Dionne, LCSW
• Kerbie Dixon, CCC-SLP
• Tamara L Dobbins
• Doctor Teeth DMD LLC
• Jeremiah Dodd
• Kathleen Doherty, OTR/L

• Psychologist in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.