Active NPI
Olivia Claire Dimatteo, PT, DPT
- Physical Therapist
- Glendale, AZ
National Provider Identifier
1093360919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13277
- Practice address
- 18001 N 79TH Ave Ste A3
Glendale, AZ 85308-8389 - Phone
- (623) 979-5266
- NPI assigned
- Aug 7, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 13277 | AZ | Primary |
Addresses
Primary practice location
18001 N 79TH Ave Ste A3
Glendale, AZ 85308-8389
Mailing address
18001 N 79TH Ave Ste A3
Glendale, AZ 85308-8389
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13277 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565136000000",
"number": "1093360919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18001 N 79TH AVE STE A3",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853088389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18001 N 79TH AVE STE A3",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853088389",
"telephone_number": "623-979-5266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMATTEO",
"first_name": "OLIVIA",
"middle_name": "CLAIRE",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-07",
"last_updated": "2019-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "AZ",
"license": "13277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.