MATOULA LUIS – Clinical Social Worker, NPI 1114757713

MATOULA LUIS is a healthcare provider. based in Watertown, Connecticut. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 10957 (CT). The NPI Number for MATOULA LUIS is 1114757713

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
MATOULA LUIS
NPI
1114757713
Phone
Not provided
Address
129 WOOLSON ST
Enumeration Date
7 August 2024
Last Update Date
7 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2036587941
Graduation Year
2016 (10 years ago)
PAC ID
8921530981
Group Practice PAC ID
2860833886
Professional Enrollment ID
I20241015002730
Address ID
CT06451XXXXMEXXXXXXXXXX00
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

2,153 CLINICAL SOCIAL WORKER in CT

Provider Addresses for MATOULA LUIS

  • 129 WOOLSON ST

    WATERTOWN, CT 067952228

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241015002730IClinical Social WorkerCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06795)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860833886View full group profile
NameSpecialtyState
Mental Health CounselorCT

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Frequently asked questions

How is MATOULA LUIS identified in CMS data?
CMS-hosted NPPES data lists MATOULA LUIS with NPI 1114757713.
Is MATOULA LUIS still practicing?
MATOULA LUIS is currently listed as active in the public NPI registry.
What is MATOULA LUIS's specialty?
The listing groups MATOULA LUIS with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What area does MATOULA LUIS serve?
MATOULA LUIS's listing highlights Watertown, Connecticut; more addresses can appear in NPPES.
Why does MATOULA LUIS have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.