MRS. ALICJA MATUSIAK (LISW-S, CNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1174757678

MRS. ALICJA MATUSIAK (LISW-S, CNP) is a healthcare provider. based in Columbus, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials LISW-S, CNP. They hold a License No. 0800345 (OH). The NPI Number for MRS. ALICJA MATUSIAK (LISW-S, CNP) is 1174757678

Main info

Female
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
MRS. ALICJA MATUSIAK (LISW-S, CNP)
NPI
1174757678
Phone
(614) 371-2303
Address
4770 INDIANOLA AVE STE 107
Enumeration Date
12 May 2009
Last Update Date
8 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6143712303
Graduation Year
2014 (12 years ago)
PAC ID
1153469978
Group Practice PAC ID
6002243755
Professional Enrollment ID
I20200428000775
Address ID
OH432141862CO4770XAVEX307
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience80
Completeness75
Years active:17State licenses:4Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for MRS. ALICJA MATUSIAK (LISW-S, CNP)

  • 4770 INDIANOLA AVE STE 107

    COLUMBUS, OH 432141862

    Phone: (614) 371-2303

    Fax: (800) 905-9950

    Type: Mailing

  • Sullivant Avenue, Columbus, Franklin, Ohio, 43228, United States

    COLUMBUS, OH 432041895

    Phone: (614) 371-2303

    Fax: (800) 905-9950

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 174 Open Payments records for all available years, with a total value of $3,303.

Total Amount is formed as General ($3,303) + Research ($0) + Ownership ($0) = $3,303.

Last reported payment date: 2024-12-23 • Largest payer in this snapshot: ABBVIE INC. ($608).

Total Amount

$3,303

General + Research + Ownership

Payments

174

Total payment records

General Amount

$3,303

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-23

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2020-04-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20091113000564IClinical Social WorkerOHTBD
I20200428000775INurse PractitionerOHTBD

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 43214)

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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: 6002243755View full group profile
NameSpecialtyState
Clinical Social WorkerOH
Clinical Social WorkerOH
Nurse PractitionerOH
Emergency MedicineOH
Nurse PractitionerNC
Clinical PsychologistPA
Nurse PractitionerOH

Reviews

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Frequently asked questions

How do payers reference MRS. ALICJA MATUSIAK (LISW-S, CNP)?
For MRS. ALICJA MATUSIAK (LISW-S, CNP), use NPI 1174757678 as the unique 10-digit identifier.
Is MRS. ALICJA MATUSIAK (LISW-S, CNP) shown as active in public data?
Registry records indicate MRS. ALICJA MATUSIAK (LISW-S, CNP) maintains an active NPI.
What area of care is associated with MRS. ALICJA MATUSIAK (LISW-S, CNP)?
MRS. ALICJA MATUSIAK (LISW-S, CNP)'s record emphasizes Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with MRS. ALICJA MATUSIAK (LISW-S, CNP)?
Directory geography for MRS. ALICJA MATUSIAK (LISW-S, CNP) centers on Columbus, Ohio.
Can I trust this NPI listing for MRS. ALICJA MATUSIAK (LISW-S, CNP)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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