Individual provider Active NPI

Matthew Stille

  • Physical Therapist
  • Naples, FL
National Provider Identifier
1043649049
Registry record updated Nov 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28822 Issued in FL
Practice address
848 1St Ave N
Ste 120
Naples, FL 34102-6013
Phone
(239) 384-5952
NPI assigned
Nov 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2013

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 PT28822 FL Primary

Addresses

Primary practice location

848 1St Ave N
Ste 120
Naples, FL 34102-6013

Mailing address

23159 Amgci Way Unit 315
Estero, FL 33928-2593
Phone (305) 606-5676

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131219001163 FL Practitioner - Physical Therapist in Private Practice 1153558150 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT28822FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimized Therapy Transitions, LLC Physical Therapist CurrentSince Apr 26, 2023 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.

NPI Registry JSON

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384128000000",
    "number": "1043649049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23159 AMGCI WAY UNIT 315",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339282593",
            "telephone_number": "305-606-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 1ST AVE N",
            "address_2": "STE 120",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341026013",
            "telephone_number": "239-384-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLE",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-11",
        "last_updated": "2013-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.