Individual provider Active NPI

Emily Margaret Matlack, DPT

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1063177111
Registry record updated Jul 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7468 Issued in ME
Practice address
3611 NM 528 NW Ste 101
Albuquerque, NM 87114-8920
Phone
(505) 217-2826
Fax
(505) 234-7431
NPI assigned
Nov 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT7468 ME Primary
Physical Therapist 225100000X NM
Physical Therapist 225100000X 12502 MN

Addresses

Primary practice location

3611 NM 528 NW Ste 101
Albuquerque, NM 87114-8920

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

4212 Grand Ave
Duluth, MN 55807-2737
Phone (218) 786-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, OR, WA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20240109002128 NM Practitioner - Physical Therapist in Private Practice 8123417698 Reassigns benefits to 1 organization
I20240424000845 OR Practitioner - Physical Therapist in Private Practice 8123417698 Reassigns benefits to 1 organization
I20250107003828 WA Practitioner - Physical Therapist in Private Practice 8123417698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.36 of 100Reported as group
Quality
88.33
Improvement activities
40
Cost
75.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of Or, LLC Physical Therapist CurrentSince May 20, 2024 Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Physical Therapy at Dawn, LLC Physical Therapist CurrentSince Jan 22, 2024 Accepting new patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist Current Accepting new patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist CurrentSince May 20, 2024 Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

790 Remington Blvd
Bolingbrook, IL 60440

3611 NM 528 NW
Ste 101
Albuquerque, NM 87114
Phone (505) 217-2826

6330 Riverside Plaza Ln NW
Albuquerque, NM 87120
Phone (505) 312-7930

3007 NE West Devils Lake Rd
Lincoln City, OR 97367
Phone (541) 994-6252

3512 Excel Dr
Ste 105
Medford, OR 97504
Phone (541) 245-0419

1880 Pottery Ave
Ste 100
Port Orchard, WA 98366
Phone (360) 859-9090

2400 NW Myhre Rd
Ste 101
Silverdale, WA 98383
Phone (360) 598-3764

2400 NW Myhre Rd
Ste 102
Silverdale, WA 98383
Phone (360) 598-3764

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": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783209600000",
    "number": "1063177111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 NM 528 NW STE 101",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871148920",
            "telephone_number": "505-217-2826",
            "fax_number": "505-234-7431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4212 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558072737",
            "country_code": "US",
            "telephone_number": "218-786-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATLACK",
        "first_name": "EMILY",
        "middle_name": "MARGARET",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2026-07-05",
        "certification_date": "2026-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT7468",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12502",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2026; 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.