MEDICARE: MATTHEW KENNETH DICENZI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1265382345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATTHEW KENNETH DICENZI

Provider Business Mailing Address
First Line	:	6728 ARLINGTON DR
Second Line	:
City	:	WESTFIELD CENTER
State	:	OH
Zip	:	44251-9718
Country	:	US
Telephone Number	:	216-375-1011
Fax Number	:

Provider Business Practice Location Address
First Line	:	10524 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-2205
Country	:	US
Telephone Number	:	440-697-5467
Fax Number	:

Authorized Official
Title or Position	:	ADVANCED PRACTICE PROVIDER
Name	:	MATTHEW KENNETH DICENZI
Credential	:	PMHNP-BC, APRN
Telephone Number	:	216-375-1011

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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