Andrew James Matusiak

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

010494 Issued in CT

Practice address

143 Pine Hill Rd
Unit 17a
Thomaston, CT 06787-1955

Phone

(860) 921-8909

NPI assigned

Jan 4, 2017

Last updated

May 6, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

Specialty

Clinical Social Worker

Education

Fordham University School of Medicine, 2016

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Challenging Minds LLCGroup PAC ID 9830429794, 7 clinicians

Practice addresses (Care Compare)

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.

• Challenging Minds LLC

  • Community/Behavioral Health Agency
  • Torrington, CT
  • NPI 1730745316

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Step Up Care PC LLC

  • Counselor
  • Danielson, CT
  • NPI 1154884740

  Clinical

  Medicare reassignment NPD
• Sunrise Psychological Services LLC

  • Psychologist
  • Prospect, CT
  • NPI 1699199869

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1801331640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 PINE HILL RD",
            "address_2": "UNIT 17A",
            "city": "THOMASTON",
            "state": "CT",
            "postal_code": "067871955",
            "telephone_number": "860-921-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 PINE HILL RD",
            "address_2": "UNIT 17A",
            "city": "THOMASTON",
            "state": "CT",
            "postal_code": "067871955",
            "telephone_number": "860-921-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUSIAK",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-04",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010494",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "3249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Little, LMFT
• Judith Lombardo, DMD
• George E. Lush, D.M.D.
• Lynn Wellcare Solutions LLC
• Shana A Marques, LCSW
• MGR Wellness Counseling LLC
• Neil Miller, MD
• Sarah Moodie, LCSW
• John P Moschello, MD
• Nicole Hennessy LCSW PLLC

• Clinical Social Worker in Thomaston, CT
• Providers in Thomaston, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.
• 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.