MATTHEW J DZAK (PSYD, HSPP) – Clinical Psychologist, NPI 1841544681
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MATTHEW J DZAK (PSYD, HSPP)
104 W MAIN ST
PIERCE CITY, MO 657231210
Phone: (417) 476-1000
Type: Mailing
530 S Maiden Ln
Joplin, MO 648013084
Phone: (417) 782-6200
Type: Location
302 NE 14TH ST
LEON, IA 501441206
Phone: (641) 446-2383
Fax: (641) 446-2382
Type: Mailing
221 E STATE ST
CENTERVILLE, IA 525441813
Phone: (641) 446-2383
Type: Location
1701 N CENTRAL AVE
MONETT, MO 65708
Phone: (417) 235-6610
Type: Location
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.
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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: 2020-06-01
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 |
|---|---|---|---|---|
| I20200601000889 | I | Clinical Psychologist | MO | 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 65723)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IA | |
| Mental Health Counselor | IA | |
| - | IA | |
| - | IA | |
| O P T O M E T R Y | IA | |
| Nurse Practitioner | IA | |
| Clinical Social Worker | LA | |
| Nurse Practitioner | IA | |
| Clinical Social Worker | IA | |
| Internal Medicine | IA |
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