Active NPI
Matthew Tyler Bertrand, PTA
- Physical Therapy Assistant
- Midland, TX
National Provider Identifier
1003050832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2063642
- Practice address
- 4610 N Garfield St
Suite B-5
Midland, TX 79705-2663 - Phone
- (432) 570-8782
- Fax
- (432) 683-8476
- NPI assigned
- Apr 23, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2063642 | TX | Primary |
Addresses
Primary practice location
4610 N Garfield St
Suite B-5
Midland, TX 79705-2663
Mailing address
4610 N Garfield St
Suite B-5
Midland, TX 79705-2663
Phone (432) 570-8782
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2063642 | TX | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| T-Star, PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Midland, TX
- NPI 1982746830
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240444800000",
"number": "1003050832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4610 N GARFIELD ST",
"address_2": "SUITE B-5",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797052663",
"telephone_number": "432-570-8782",
"fax_number": "432-683-8476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4610 N GARFIELD ST",
"address_2": "SUITE B-5",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797052663",
"telephone_number": "432-570-8782",
"fax_number": "432-683-8476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTRAND",
"first_name": "MATTHEW",
"middle_name": "TYLER",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-23",
"last_updated": "2009-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2063642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.