Individual provider Active NPI

Matthew A Reis, PT, DPT

  • Physical Therapist
  • Hackensack, NJ
National Provider Identifier
1083046304
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01771700 Issued in NJ
Practice address
454 Passaic St
Hackensack, NJ 07601-1519
Phone
(201) 488-7905
Fax
(201) 488-7901
NPI assigned
Aug 9, 2013
Last updated
Oct 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE009558 PA
Physical Therapist 225100000X 40QA01771700 NJ Primary

Addresses

Primary practice location

454 Passaic St
Hackensack, NJ 07601-1519

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (888) 830-4125

Other practice location 1

145 Piermont Rd
Tenafly, NJ 07670-1022
Phone (201) 568-3355

Other practice location 2

1324 N Church St
Suite #4
Hazle Township, PA 18202-9307
Phone (570) 501-1808

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180302000041 NJ Practitioner - Physical Therapist in Private Practice 1850652181 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

454 Passaic St
Hackensack, NJ 07601-1519
Phone (201) 488-7905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TE009558PAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Physical Therapy Limited Partnership Physical Therapist CurrentSince Jan 15, 2018 Accepting new patients
Ivyrehab Network Inc. Physical Therapist Current Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Oct 11, 2021 Accepting new patients
Ivyrehab Network Inc Physical Therapist CurrentSince Oct 11, 2021 Accepting new patients
Hazleton Physical Therapy, LLC Physical Therapist PastSince Mar 27, 2012 Accepting new patients
Madison PT of New Jersey, PC Physical Therapist Past Accepting new patients

Locations

105 Union Ave
Cresskill, NJ 07626

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

219 Richmond Ave
New Milford, NJ 07646
Phone (201) 907-3150

400 State Rt 17
Ste 1
Ridgewood, NJ 07450
Phone (201) 445-8600

444 Hurffville Crosskeys Rd
Sewell, NJ 08080
Phone (856) 218-2677

145 Piermont Rd
Tenafly, NJ 07670
Phone (201) 568-3355

354 Old Hook Rd
Ste G1
Westwood, NJ 07675
Phone (201) 594-9312

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

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, 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": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1083046304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "888-830-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 PASSAIC ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011519",
            "telephone_number": "201-488-7905",
            "fax_number": "201-488-7901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Piermont Rd",
            "address_purpose": "LOCATION",
            "city": "Tenafly",
            "state": "NJ",
            "postal_code": "076701022",
            "country_code": "US",
            "telephone_number": "201-568-3355",
            "fax_number": "201-568-3350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1324 N Church St",
            "address_2": "Suite #4",
            "address_purpose": "LOCATION",
            "city": "Hazle Township",
            "state": "PA",
            "postal_code": "182029307",
            "country_code": "US",
            "telephone_number": "570-501-1808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REIS",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-09",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE009558",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01771700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.