MR. AUGUST SUPAN (MSW) – Clinical Social Worker, NPI 1598851040

MR. AUGUST SUPAN (MSW) is a healthcare provider. based in Mattoon, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW. They hold a License No. 149-007817 (IL). The NPI Number for MR. AUGUST SUPAN (MSW) is 1598851040

Main info

Male
53 Years Of Experience
Accepts Medicare Assignment
Name
MR. AUGUST SUPAN (MSW)
NPI
1598851040
Phone
(217) 238-5700
Address
750 BROADWAY AVE E
Enumeration Date
4 October 2006
Last Update Date
4 August 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2172385700
Graduation Year
1973 (53 years ago)
PAC ID
5395910731
Group Practice PAC ID
9537194329
Professional Enrollment ID
I20111213000495
Address ID
IL619384610MA750XXEXXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

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Provider Addresses for MR. AUGUST SUPAN (MSW)

  • Broadway Avenue East, Mattoon, Coles County, Illinois, 61938, United States

    MATTOON, IL 619384610

    Phone: (217) 238-5700

    Fax: (217) 238-5767

    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: 2011-12-13

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
I20111213000495IClinical Social WorkerILTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes16822$0
90791Psychiatric diagnostic evaluation2919$0
View full utilization report →

Insurance plans in this area (ZIP 61938)

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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: 9537194329View full group profile
NameSpecialtyState
Mental Health CounselorIL
Mental Health CounselorIL
-IL
-IL
Mental Health CounselorIL
Mental Health CounselorIL
Mental Health CounselorIL
Mental Health CounselorIL
Mental Health CounselorIL

Reviews

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Frequently asked questions

How is MR. AUGUST SUPAN (MSW) identified in CMS data?
CMS-hosted NPPES data lists MR. AUGUST SUPAN (MSW) with NPI 1598851040.
Can I rely on MR. AUGUST SUPAN (MSW) being an active provider?
As of the registry snapshot, MR. AUGUST SUPAN (MSW) is marked active.
What is MR. AUGUST SUPAN (MSW)'s primary classification?
Clinical Social Worker is the headline specialty for MR. AUGUST SUPAN (MSW) here. Clinical services aligned with this taxonomy classification.
Where is MR. AUGUST SUPAN (MSW) based?
MR. AUGUST SUPAN (MSW) is tied to Mattoon, Illinois in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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