Individual provider Active NPI

Matthew Justin Schmidt, P.T.

  • Physical Therapist
  • Blackwood, NJ
National Provider Identifier
1073775755
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00402300 Issued in NJ
Practice address
141 S Black Horse Pike
Suite #3
Blackwood, NJ 08012-2975
Phone
(856) 227-3215
Fax
(856) 232-3190
NPI assigned
Jun 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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 40QA00402300 NJ Primary

Addresses

Primary practice location

141 S Black Horse Pike
Suite #3
Blackwood, NJ 08012-2975

Mailing address

141 S Black Horse Pike
Suite #3
Blackwood, NJ 08012-2975
Phone (856) 227-3215

Other identifiers 6

IdentifierTypeStateIssuer
000458043OtherPABLUE CROSS/BLUE SHIELD
0106235OtherNJAMERIHEALTH
0106235OtherPAAMERIHEALTH
000458043OtherNJBLUE CROSS/BLUE SHIELD
0106235OtherNJAETNA
0106235OtherPAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1073775755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 S BLACK HORSE PIKE",
            "address_2": "SUITE #3",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122975",
            "telephone_number": "856-227-3215",
            "fax_number": "856-232-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 S BLACK HORSE PIKE",
            "address_2": "SUITE #3",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122975",
            "telephone_number": "856-227-3215",
            "fax_number": "856-232-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "MATTHEW",
        "middle_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00402300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000458043",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0106235",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0106235",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000458043",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0106235",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0106235",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.