Individual provider Active NPI

Matthew Impallaria

  • Physical Therapist
  • Conifer, CO
National Provider Identifier
1083533954
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0021494 Issued in CO
Practice address
25577 Conifer Rd Unit 125
Conifer, CO 80433-9068
Phone
(303) 838-7444
NPI assigned
Jul 14, 2026
Last updated
Aug 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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 PTL.0021494 CO Primary

Addresses

Primary practice location

25577 Conifer Rd Unit 125
Conifer, CO 80433-9068

Mailing address

1324 Cherry Laurel Cir
Webster, NY 14580-9466

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1783987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1083533954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 CHERRY LAUREL CIR",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145809466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25577 CONIFER RD UNIT 125",
            "city": "CONIFER",
            "state": "CO",
            "postal_code": "804339068",
            "telephone_number": "303-838-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMPALLARIA",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-14",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0021494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conifer, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.