MATTHEW ELLAM (CNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1083006696
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,971 NURSE PRACTITIONER in MA
Provider Addresses for MATTHEW ELLAM (CNP)
63 MAIN ST
BROCKTON, MA 023014042
Phone:
Type: Mailing
6 Liberty Sq # 96730
Boston, MA 021095800
Phone: (617) 286-6764
Type: Location
6 LIBERTY SQ # 96730
BOSTON, MA 021095800
Phone:
Type: Mailing
1330 BEACON ST STE 202
BROOKLINE, MA 024463202
Phone: (617) 354-4450
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $353.
Total Amount is formed as General ($353) + Research ($0) + Ownership ($0) = $353.
Last reported payment date: 2024-08-07 • Largest payer in this snapshot: Neurocrine BioSciences, Inc. ($254).
Total Amount
$353
General + Research + Ownership
Payments
11
Total payment records
General Amount
$353
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Neurocrine BioSciences, Inc. | $254 |
| ABBVIE INC. | $68 |
| Axsome Therapeutics, Inc. | $32 |
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: 2017-01-18
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170118000782 | I | Nurse Practitioner | MA | TBD |
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.
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 02301)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | MA | |
| Mental Health Counselor | MA | |
| Clinical Social Worker | MA | |
| Mental Health Counselor | MA | |
| Nurse Practitioner | MA | |
| Mental Health Counselor | MA | |
| Clinical Social Worker | MA | |
| Clinical Social Worker | MA | |
| Nurse Practitioner | MA | |
| Nurse Practitioner | NV |
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