DR. MATTHEW J NIEDZWIECKI (MD) – Psychiatry Physician, NPI 1174859284
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,132 PSYCHIATRY in TX
Provider Addresses for DR. MATTHEW J NIEDZWIECKI (MD)
4810 Riverstone Blvd Ste 100
Missouri City, TX 774594092
Phone: (281) 836-4735
Type: Location
500 W Court St
Kankakee, IL 609013661
Phone: (281) 836-4735
Type: Location
11 S MAIN ST STE 200
CONCORD, NH 033014846
Phone: (401) 390-6297
Type: Mailing
11332 MOUNTAIN VIEW AVE STE C
LOMA LINDA, CA 923543854
Phone: (401) 390-6297
Type: Location
Butler Hospital, 345, Blackstone Boulevard, Blackstone, Providence, Providence County, Rhode Island, 02906-4800, United States
PROVIDENCE, RI 029064800
Phone: (401) 455-6314
Type: Mailing
500 W COURT ST
KANKAKEE, IL 609013661
Phone: (281) 836-4735
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.
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: 2025-06-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 7 Medicare enrollment records; no due dates published yet.
Enrollment records
7
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 |
|---|---|---|---|---|
| I20180116001876 | I | Psychiatry | WA | TBD |
| I20180416001137 | I | Psychiatry | NC | TBD |
| I20190701001671 | I | Psychiatry | MT | TBD |
| I20220401001021 | I | Psychiatry | WI | TBD |
| I20231009001272 | I | Psychiatry | IL | TBD |
| I20240109003596 | I | Psychiatry | CA | TBD |
| I20250603003813 | I | Psychiatry | TX | 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 77459)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TX | |
| Nurse Practitioner | TX | |
| - | TX | |
| Nurse Practitioner | TX | |
| Clinical Social Worker | TX | |
| P S Y C H I A T R Y | TX | |
| P S Y C H I A T R Y | TX | |
| Mental Health Counselor | TX | |
| - | TX | |
| Nurse Practitioner | MN |
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