Matthew Lautner, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501303492 Issued in MI

Practice address

404 Perry Ave Ste B
Big Rapids, MI 49307-2246

Phone

(231) 753-1236

Fax

(231) 867-9006

NPI assigned

Sep 18, 2024

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 MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Michigan LLCGroup PAC ID 6901165893, 156 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Ivyrehab Northern PT, LLC

  • Physical Therapy Clinic/Center
  • Sparta, MI
  • NPI 1972592525
  NPD (past)

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1073340550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412031",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022414664",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 PERRY AVE STE B",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072246",
            "telephone_number": "231-753-1236",
            "fax_number": "231-867-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTNER",
        "first_name": "MATTHEW",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Ginelle Lane
• Amanda Lash
• Molly Laskowski
• Matthew Lathrop, CCAR
• David Stanley Launder, PA
• Trina Leigeb, BSDH RDH
• Karen Sue Leiter, NP
• Kristen Marie Leonard, PT
• Mackenzie Rae Lewis, FNP
• Jason Li

• Physical Therapist in Big Rapids, MI
• Providers in Big Rapids, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.