Matthew Paul Staniewicz, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

4954 Issued in CT

Practice address

121 Wakelee Avenue
Acs
Ansonia, CT 06401-1198

Phone

(203) 503-3650

Fax

(203) 503-3659

NPI assigned

Oct 11, 2019

Last updated

Oct 11, 2019By the provider in NPPES

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 CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cornell Scott Hill Health Corporation

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1902921380
  Medicare reassignment NPD
• Matthew Staniewicz LCSW

  • Clinical Social Worker
  • New Haven, CT
  • NPI 1679324420
  NPD Authorized official

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1770125734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVENUE",
            "address_2": "CREDENTIALING SPECIALIST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3000",
            "fax_number": "203-503-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WAKELEE AVENUE",
            "address_2": "ACS",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064011198",
            "telephone_number": "203-503-3650",
            "fax_number": "203-503-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANIEWICZ",
        "first_name": "MATTHEW",
        "middle_name": "PAUL",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "4954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milton A Soriano, MSW
• Michelle Marie Sousa-Paco, MA
• Southern Connecticut Dental Group PC
• Spectrum Healthcare Waterbridge, LLC (Hilltop Health Center)
• Roman Spivak, MD
• Mary Ellie Stankus, APRN, RN
• Ira J Stein, DDS
• Stephen Moses, M.D., LLC
• Jennifer L Stevens, LPC
• Patrick Stone, LPC

• Social Worker in Ansonia, CT
• Providers in Ansonia, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.