Individual provider Active NPI

Jonathan Dematteis, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1053362905
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27873 Issued in NY
Practice address
16 E 52ND St
6TH Floor
New York, NY 10022-5306
Phone
(212) 752-2400
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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 27873 NY Primary

Addresses

Primary practice location

16 E 52ND St
6TH Floor
New York, NY 10022-5306

Mailing address

2333 205TH St
Bayside, NY 11360-1345
Phone (212) 752-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061016000501 NY Practitioner - Physical Therapist in Private Practice 9436155363 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16 E 52ND St
FL 6
New York, NY 10022-5306
Phone (212) 752-2400

244 E 84TH St
New York, NY 10028-2904
Phone (212) 570-0209

44 Saint Marks PL
New York, NY 10003-8118
Phone (212) 529-5966

Merit-based Incentive Payment System (MIPS)

Final score
96.35 of 100Reported as individual
Quality
95.71
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27873NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
American Edge Physical Therapy, P.C. Physical Therapist CurrentSince Jul 15, 2024 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Aug 1, 2023 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Aug 1, 2023 Accepting new patients

Locations

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

90 Northern Blvd
Greenvale, NY 11548
Phone (516) 626-5080

576 Broadhollow Rd
Melville, NY 11747

244 E 84th St
Fl 3
New York, NY 10028
Phone (212) 570-0209

16 E 52nd St
Fl 6
New York, NY 10022
Phone (212) 752-2400

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 6

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1053362905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 205TH ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601345",
            "telephone_number": "212-752-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E 52ND ST",
            "address_2": "6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225306",
            "telephone_number": "212-752-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMATTEIS",
        "first_name": "JONATHAN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "27873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; 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.