Individual provider Active NPI

Matthew A Massey, DPT

  • Physical Therapist
  • Roeland Park, KS
National Provider Identifier
1093561854
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-07117 Issued in KS
Practice address
5675 Roe Blvd Ste 240
Roeland Park, KS 66205-2515
Phone
(913) 632-4750
Fax
(913) 320-0302
NPI assigned
Apr 24, 2024
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 11-07117 KS Primary

Addresses

Primary practice location

5675 Roe Blvd Ste 240
Roeland Park, KS 66205-2515

Mailing address

5675 Roe Blvd Ste 240
Roeland Park, KS 66205-2515
Phone (913) 632-4750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812002029 KS Practitioner - Physical Therapist in Private Practice 1557809365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9828 E Shannon Woods Cir
Suite 200
Wichita, KS 67226-4100
Phone (316) 274-3540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-07117KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Via Christi Rehabilitation Hospital, Inc. Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients
Ascension Via Christi Rehabilitation Hospital, Inc. Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients
Shawnee Mission Medical Center, Inc. PastSince Apr 28, 2024 Accepting new patients
Via Christi Rehabilitation Hospital, Inc Physical Therapist Past Accepting new patients

Locations

1151 N Rock Rd
Wichita, KS 67206
Phone (316) 634-3400

Organizations & group practices 4

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": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1093561854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5675 ROE BLVD STE 240",
            "city": "ROELAND PARK",
            "state": "KS",
            "postal_code": "662052515",
            "telephone_number": "913-632-4750",
            "fax_number": "913-320-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 ROE BLVD STE 240",
            "city": "ROELAND PARK",
            "state": "KS",
            "postal_code": "662052515",
            "telephone_number": "913-632-4750",
            "fax_number": "913-320-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSEY",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-07117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roeland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.