Individual provider Active NPI

Matthew Karl Thompson, RPT

  • Physical Therapist
  • Melbourne, FL
National Provider Identifier
1083696884
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT10471 Issued in FL
Practice address
308 S Harbor City Blvd
Suite B
Melbourne, FL 32901-1500
Phone
(321) 951-2416
Fax
(321) 951-2077
NPI assigned
Nov 17, 2005
Last updated
Oct 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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 PT10471 FL Primary

Addresses

Primary practice location

308 S Harbor City Blvd
Suite B
Melbourne, FL 32901-1500

Mailing address

4957 Rosewood LN
Melbourne, FL 32940-7168
Phone (321) 951-2416

Other identifiers 2

IdentifierTypeStateIssuer
Y6308OtherFLBLUE CROSS/BLUE SHIELD PR
888624500MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101104001035 FL Practitioner - Physical Therapist in Private Practice 2264335017 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbor City Physical Therapy, PAGroup PAC ID 9335167790, 7 clinicians

Practice addresses (Care Compare)

307 E New Haven Ave
Suite 2
Melbourne, FL 32901-4576
Phone (321) 953-3991

Merit-based Incentive Payment System (MIPS)

Final score
96.19 of 100Reported as group
Promoting interoperability
92
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor City Physical Therapy, PA Physical Therapist CurrentSince Jan 2, 2024 Accepting new patients
Florida Pain and Rehabilitation Associates Inc Current Accepting new patients
National Surgical Centers of America LLC CurrentSince Nov 1, 2019 Accepting new patients
Florida Pain and Rehabilitation Associates Inc CurrentSince Jan 1, 2017 Accepting new patients
National Surgical Centers of America LLC CurrentSince Nov 1, 2019 Accepting new patients
Florida Pain and Rehabilitation Associates Inc CurrentSince Jan 1, 2017 Accepting new patients
National Surgical Centers of America LLC CurrentSince Nov 1, 2019 Accepting new patients

Locations

5365 Atlantic Ave
Ste 501
Delray Beach, FL 33484
Phone (561) 279-3500

307 E New Haven Ave
Ste 2
Melbourne, FL 32901
Phone (321) 953-3991

308 S Harbor City Blvd
Ste A
Melbourne, FL 32901
Phone (321) 254-9060

5000 N Wickham Rd
Ste 107
Melbourne, FL 32940
Phone (321) 701-4020

150 SW Chamber Ct
Ste 105
Port St Lucie, FL 34986
Phone (772) 807-9000

389 Commerce Pkwy
Ste 100
Rockledge, FL 32955
Phone (321) 305-6567

389 Commerce Pkwy
Ste 120
Rockledge, FL 32955
Phone (321) 639-0344

13945 N US Highway 441
The Villages, FL 32159
Phone (352) 277-3500

1693 Lee Rd
Ste A
Winter Park, FL 32789
Phone (407) 287-4300

1693 Lee Rd
Ste B
Winter Park, FL 32789
Phone (407) 622-5766

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: mthompson@nationalspine.emadirect.md

Organizations & group practices 8

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1083696884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4957 ROSEWOOD LN",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407168",
            "telephone_number": "321-951-2416",
            "fax_number": "321-951-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 S HARBOR CITY BLVD",
            "address_2": "SUITE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011500",
            "telephone_number": "321-951-2416",
            "fax_number": "321-951-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MATTHEW",
        "middle_name": "KARL",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT10471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD PR",
            "identifier": "Y6308",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "888624500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.