NPIMap

Organization Active NPI

Matrix Integrated Psychological Services

Doing business as Matrix Psychological Services

  • Psychologist
  • Columbus, OH
National Provider Identifier
1902079478
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MATRIX INTEGRATED PSYCHOLOGICAL SERVICES
Doing business as
Matrix Psychological Services
Practice address
2 Easton Oval
Ste 450
Columbus, OH 43219-6036
Phone
(614) 475-9500
Fax
(614) 475-9821
NPI assigned
Apr 7, 2008
Last updated
Jan 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Authorized official

Name
Kurt Malkoff, PH.D.NPI 1972697852
Title
President
Phone
(614) 475-9500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X OH
Psychologist 103T00000X OH Primary

Addresses

Primary practice location

2 Easton Oval
Ste 450
Columbus, OH 43219-6036

Mailing address

2 Easton Oval
Ste 450
Columbus, OH 43219-6036
Phone (614) 475-9500

Other names 1

  • Matrix Psychological Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090304000851 OH Part B Supplier - Clinic/Group Practice 4880750512 Receives reassigned benefits from 26 practitioners
Practice locations: Columbus, OH; Dublin, OH

National Provider Directory

National Provider Directory

Locations

110 Northwoods Blvd
Ste B1
Columbus, OH 43235
Phone (614) 475-9500

1405 Dublin Rd
Ste 150
Columbus, OH 43215
Phone (614) 475-9500

2 Easton Oval
Ste 450
Columbus, OH 43219
Phone (614) 475-9500

249 E Livingston Ave
Ste B
Columbus, OH 43215
Phone (513) 515-2580

5060 Bradenton Ave
Ste D
Dublin, OH 43017
Phone (614) 475-9500

Practitioners & affiliated clinicians

Practitioners 55

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421193600000",
    "number": "1902079478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 EASTON OVAL",
            "address_2": "STE 450",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196036",
            "telephone_number": "614-475-9500",
            "fax_number": "614-475-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EASTON OVAL",
            "address_2": "STE 450",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196036",
            "telephone_number": "614-475-9500",
            "fax_number": "614-475-9821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX INTEGRATED PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2015-01-14",
        "status": "A",
        "authorized_official_last_name": "MALKOFF",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-475-9500",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matrix Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.