Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1932835238 Individual Practitioner Male Practitioner

Antonio Jamaal Wideman , PEER SPECIALIST

Peer Specialist • Mattapan, MA

Professional Overview & Biography Verified Profile Summary

Antonio Wideman, PEER SPECIALIST is a registered healthcare professional specializing in Peer Specialist in Mattapan, MA. Practice services are available at 884 CUMMINS HWY APT 4 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

884 Cummins Hwy Apt 4

Mattapan, MA 021262043

Telephone 6176916034
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Mattapan, MA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Mattapan, MA (294 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-07-28
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

State License MA 202222

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 28, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location July 28, 2022

Registered at 884 CUMMINS HWY APT 4, MATTAPAN, MA 021262043 (Tel: 6176916034)

📍
Updated Business Mailing Address July 28, 2022

Registered at 884 CUMMINS HWY APT 4, MATTAPAN, MA 021262043 (Tel: 6176916034)

👤
Provider Name / Credentials Updated July 28, 2022

Recorded as ANTONIO WIDEMAN, PEER SPECIALIST

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 28, 2022

Peer Specialist (License #202222 in MA)

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Initial NPI Registration & Enumeration July 28, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1932835238
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 28, 2022
Last Update: July 28, 2022
Sole Proprietor: Yes

Mailing Address

884 Cummins Hwy Apt 4

Mattapan, MA 021262043

Phone: 6176916034

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.