Matthew Reiot Klebenow, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.004830 Issued in IL

Practice address

852A Sharp Drive
Provena Physical Therapy & Industrial Rehab. Center
Shorewood, IL 60404

Phone

(815) 741-7416

Fax

(815) 741-0774

NPI assigned

Aug 13, 2012

Last updated

Aug 13, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

At Home by Enhance Therapies LLCGroup PAC ID 4183033210, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• At Home by Enhance Therapies LLC

  • Physical Therapist
  • Lakewood, NJ
  • NPI 1124603246

  IL, Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Mercy Medical Center - Aurora LLC

  dba Prime Healthcare Rx 1005

  • Community/Retail Pharmacy
  • Aurora, IL
  • NPI 1215025762
  NPD (past)
• Saint Joseph Medical Center - Joliet LLC

  dba Saint Joseph Medical Center

  • Psychiatric Hospital Unit
  • Joliet, IL
  • NPI 1548079320
  NPD (past)

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1043567720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 NORTH MADISON",
            "address_2": "PROVENA SAINT JOSEPH MEDICAL CENTER",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "60435",
            "telephone_number": "815-741-7416",
            "fax_number": "815-741-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852A SHARP DRIVE",
            "address_2": "PROVENA PHYSICAL THERAPY & INDUSTRIAL REHAB. CENTER",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "60404",
            "telephone_number": "815-741-7416",
            "fax_number": "815-741-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEBENOW",
        "first_name": "MATTHEW",
        "middle_name": "REIOT",
        "name_prefix": "Mr.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.004830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas C Kaley, PHARMD
• Jill Marie Kaspar, MPT
• Barbara Kellogg, COTA/L
• Janet Kendall, RPH
• Traci Lynne Keyster, FNP
• Kelsey Margaret Knarr, MA. CFY-SLP
• Colleen Koontz
• Samantha Kothapalli, DMD
• Briana Nicole Kregas, OTR/L
• April D Kubinski, MSN FPA-APRN

• Occupational Therapist in Shorewood, IL
• Providers in Shorewood, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.