Individual provider Active NPI

Joshua Mattison

  • Physical Therapist
  • Rochester, MN
National Provider Identifier
1013757764
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13468 Issued in MN
Practice address
4229 W Frontage Rd N
Rochester, MN 55901-4310
Phone
(507) 322-3460
NPI assigned
May 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13468 MN Primary

Addresses

Primary practice location

4229 W Frontage Rd N
Rochester, MN 55901-4310

Mailing address

3100 19TH St NW Ste 200
Rochester, MN 55901-6606
Phone (507) 322-3460

Other practice location 1

133 St Paul St SW
Preston, MN 55965
Phone (507) 322-3460

Other practice location 2

3020 Broadway Ave N
Rochester, MN 55906-3974
Phone (507) 322-3460

Other practice location 3

3708 Broadway Ave N Ste 110
Rochester, MN 55906-4159
Phone (507) 322-3460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240612002795 MN Practitioner - Physical Therapist in Private Practice 3173065588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Activept, Corp.Group PAC ID 9931279932, 76 clinicians

Practice addresses (Care Compare)

3708 Broadway Ave N
Suite 110
Rochester, MN 55906-4159
Phone (507) 322-3460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Activept Corp CurrentSince Jun 1, 2024 Accepting new patients
Pursuitpt LLC Physical Therapist PastSince Mar 7, 2021 Accepting new patients

Locations

133 Saint Paul St SW
Preston, MN 55965

4229 W Frontage Rd N
Rochester, MN 55901

3020 Broadway Ave N
Rochester, MN 55906

3100 19th St NW
Ste 200
Rochester, MN 55901

3708 N Broadway
Ste 110
Rochester, MN 55906

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1013757764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 19TH ST NW STE 200",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559016606",
            "telephone_number": "507-322-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4229 W FRONTAGE RD N",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559014310",
            "telephone_number": "507-322-3460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 St Paul St SW",
            "address_purpose": "LOCATION",
            "city": "Preston",
            "state": "MN",
            "postal_code": "55965",
            "country_code": "US",
            "telephone_number": "507-322-3460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3020 Broadway Ave N",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559063974",
            "country_code": "US",
            "telephone_number": "507-322-3460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3708 Broadway Ave N Ste 110",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559064159",
            "country_code": "US",
            "telephone_number": "507-322-3460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTISON",
        "first_name": "JOSHUA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "13468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.