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MATTHEW CLARK
NPI 1417353996
Counselor - Professional in Windsor, CT

Active since November 12, 2014PECOS EnrolledAccepts Medicare Assignment
360 BLOOMFIELD AVE, STE 301, WINDSOR, CT 06095(860) 607-3235(860) 607-3201 Get Directions Write a Review

NPPES record last updated: January 5, 2017. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jan 5, 2017, Nov 19, 2016 (2 updates tracked since 2016).

About Matthew Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MATTHEW CLARK (NPI 1417353996) is an individual professional provider in Windsor, Connecticut, licensed in Connecticut (002674) and active in the NPI registry since November 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1417353996
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMATTHEW CLARK
Location Address360 BLOOMFIELD AVE, STE 301Windsor, CT 06095-2700
Mailing Address360 Bloomfield Ave, Ste 301Windsor, CT 06095-2700 · (860) 607-3235 · Fax (860) 607-3201
Phone(860) 607-3235
Fax(860) 607-3201
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateNovember 12, 2014
Last NPPES UpdateJanuary 5, 20172 updates tracked since enumeration
✔ NPI 1417353996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in CT · 002674
360 BLOOMFIELD AVE, Windsor, CT 06095
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Matthew Clark is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880031947
PECOS Enrollment IDI20240325002708
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KARLEISHA BARONETTE
Behavior Analyst
360 BLOOMFIELD AVE
WINDSOR, CT 06095
Capitol Planning Region (954) 370-8999
KENDRA OWENS
Behavior Technician
360 BLOOMFIELD AVE
WINDSOR, CT 06095
Capitol Planning Region (877) 418-2978
TIANA QUINN
Behavior Technician
360 BLOOMFIELD AVE
WINDSOR, CT 06095
Capitol Planning Region (877) 418-2978
JOHANNA ORTEGA
Behavior Technician
360 BLOOMFIELD AVE
WINDSOR, CT 06095
Capitol Planning Region (754) 336-3892
ALEXANDRIA R JONES
Behavior Technician
360 BLOOMFIELD AVE
WINDSOR, CT 06095
Capitol Planning Region (877) 418-2978
LYNN ANN CAPPA
Behavior Technician
360 BLOOMFIELD AVE
WINDSOR, CT 06095
Capitol Planning Region (866) 886-2539
MYALIZ LOPEZ
Behavior Technician
360 BLOOMFIELD AVE
WINDSOR, CT 06095
Capitol Planning Region (877) 418-2978
SEAN B MONAGHAN
Behavior Technician
360 BLOOMFIELD AVE
WINDSOR, CT 06095
Capitol Planning Region (860) 674-1824

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Clark's NPI number?

The NPI number for Matthew Clark is 1417353996. It was assigned to this individual provider in the NPPES registry on November 12, 2014.

Where is Matthew Clark located?

Matthew Clark practices at 360 Bloomfield Ave Ste 301, Windsor, CT 06095. The listed phone number is (860) 607-3235.

What is Matthew Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Matthew Clark enrolled in Medicare?

Yes. Matthew Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Matthew Clark accept?

Health plans from Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care and Providence Health Plan list Matthew Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Matthew Clark was last updated on January 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.