Individual provider Active NPI

Matthew Calendrillo, DPT, BOCO

  • Specialist
  • Suffield, CT
National Provider Identifier
1043475098
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
007740 Issued in CT
Practice address
68 Bridge Street
Suite 111
Suffield, CT 06078-3107
Phone
(860) 254-5190
Fax
(860) 254-5190
NPI assigned
Jul 18, 2008
Last updated
Feb 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 007740 CT Primary
Physical Therapist 225100000X 24148 MA

Addresses

Primary practice location

68 Bridge Street
Suite 111
Suffield, CT 06078-3107

Mailing address

68 Bridge St
Suite 111
Suffield, CT 06078-3107
Phone (860) 254-5190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081119000673 CT Practitioner - Physical Therapist in Private Practice 0042370165 Reassigns benefits to 1 organization
I20191213000820 MA Practitioner - Physical Therapist in Private Practice 0042370165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Live Every Day L.L.CGroup PAC ID 4284839176, 6 clinicians

Practice addresses (Care Compare)

138 Hopmeadow St
Simsbury, CT 06089-9793
Phone (860) 413-2073

258 Middlesex St
Springfield, MA 01109-2826
Phone (860) 413-2073

768 S St
Suffield, CT 06078-2514
Phone (860) 413-2073

Merit-based Incentive Payment System (MIPS)

Final score
21.19 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
70.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007740CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Live Every Day LLC Physical Therapist CurrentSince Jul 27, 2007 Accepting new patients
Live Every Day Past Accepting new patients
Live Every Day L.L.C Past Accepting new patients
Physical Therapy Plus LLC Physical Therapist PastSince Apr 23, 2012 Accepting new patients

Locations

68 Bridge St
Unit 111
Suffield, CT 06078
Phone (860) 254-5190

138 Hopmeadow St
Weatogue, CT 06089
Phone (860) 413-2073

258 Middlesex St
Springfield, MA 01109
Phone (860) 413-2073

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1043475098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 BRIDGE ST",
            "address_2": "SUITE 111",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060783107",
            "telephone_number": "860-254-5190",
            "fax_number": "860-254-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 BRIDGE STREET",
            "address_2": "SUITE 111",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060783107",
            "telephone_number": "860-254-5190",
            "fax_number": "860-254-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALENDRILLO",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "DPT, BOCO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-18",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "007740",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "24148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.