Individual provider Active NPI

Matthew Beier Hankes, PT, ATC

  • Physical Therapist
  • Barron, WI
National Provider Identifier
1073783932
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-2848 Issued in ID
Practice address
1222 E Woodland Ave
Barron, WI 54812-1765
Phone
(715) 537-9905
NPI assigned
Mar 6, 2008
Last updated
Jul 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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 PT-2848 ID Primary

Addresses

Primary practice location

1222 E Woodland Ave
Barron, WI 54812-1765

Mailing address

1917 N Lakewood Dr
Coeur D Alene, ID 83814-2634
Phone (208) 664-8194

Other identifiers 1

IdentifierTypeStateIssuer
36164300MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110711000514 ID Practitioner - Physical Therapist in Private Practice 4880768274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shellman Inc PAGroup PAC ID 4981592938, 45 clinicians

Practice addresses (Care Compare)

1551 E Mullan Ave
Suite 102
Post Falls, ID 83854-9005
Phone (208) 773-8111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-2848IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shellman Inc PA Physical Therapist CurrentSince Jul 21, 2015 Accepting new patients
Summit Rehabilitation Associates, PLLC Physical Therapist PastSince Jul 11, 2011 Accepting new patients

Locations

1917 N Lakewood Dr
Coeur D Alene, ID 83814
Phone (208) 664-8194

1172 W Hayden Ave
Hayden, ID 83835
Phone (208) 762-3332

1551 E Mullan Ave
Ste 102
Post Falls, ID 83854
Phone (208) 262-2328

Organizations & group practices 2

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": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1073783932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 N LAKEWOOD DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142634",
            "telephone_number": "208-664-8194",
            "fax_number": "208-667-1847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 E WOODLAND AVE",
            "city": "BARRON",
            "state": "WI",
            "postal_code": "548121765",
            "telephone_number": "715-537-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANKES",
        "first_name": "MATTHEW",
        "middle_name": "BEIER",
        "credential": "PT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-06",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36164300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barron, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; 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.