Andrew V Mattle, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

012202 Issued in NY

Practice address

3506 Thomas Drive
Lakeville, NY 14480

Phone

(585) 346-0060

Fax

(585) 346-0108

NPI assigned

Feb 28, 2006

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 NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1991

Medicare assignment

May accept Medicare assignment

Group practices

Physical Therapy Professionals, PCGroup PAC ID 1153486485, 4 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 and National Provider Directory roles.

• Physical Therapy Professionals, PC

  • Physical Therapist
  • Lakeville, NY
  • NPI 1083834758
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500854400000",
    "number": "1063488948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3506 THOMAS DRIVE",
            "city": "LAKEVILLE",
            "state": "NY",
            "postal_code": "14480",
            "telephone_number": "585-346-0060",
            "fax_number": "585-346-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 THOMAS DRIVE",
            "city": "LAKEVILLE",
            "state": "NY",
            "postal_code": "14480",
            "telephone_number": "585-346-0060",
            "fax_number": "585-346-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTLE",
        "first_name": "ANDREW",
        "middle_name": "V",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2017-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeview Dental
• Sandra Kae Landon
• Christine Ellen Lazarony, RPH
• Livonia Lakeville Pharmacy Inc (Livonia Pharmacy)
• Amanda Malamud, PT, DPT
• Dawn M Mattle, PT
• Nancy J Mulvaney, RPH
• Katelyn Elise Murphy, AUD
• Physical Therapy Professionals, PC
• Xiomara Restrepo-Jaramillo, D.D.S.

• Physical Therapist in Lakeville, NY
• Providers in Lakeville, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2017; 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.