Matthew Dittus

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

047137 Issued in NY

Practice address

340 Plaza Rd
Kingston, NY 12401-2975

Phone

(845) 339-4722

NPI assigned

Apr 30, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Mercy College, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kingston Physical Therapy and Sports Rehab PCGroup PAC ID 9830132885, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kingston Physical Therapy and Sports Rehab PC

  • Physical Therapist
  • Kingston, NY
  • NPI 1720158900
  Medicare reassignment Care Compare group NPD
• Kingston Physical-Occupational Therapy & Sports Rehab PLLC

  • Occupational Therapist
  • Kingston, NY
  • NPI 1780634667

  Physical Therapist

  NPD

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691280000000",
    "number": "1104409853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 PLAZA RD",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012975",
            "telephone_number": "845-339-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 PLAZA RD",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012975",
            "telephone_number": "845-339-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTUS",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-30",
        "last_updated": "2023-08-06",
        "certification_date": "2023-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Diacovo, DMD
• Nancy Ellen Dib
• Ann Marie Dibella
• Tina M Dierna, LMSW
• Aneta K Dimova, M.D.
• Kevin K Dodd, MD
• Dominique Delma MD PC
• Cheryl Anne Donahue, P.T.
• Chelsea Donlin
• Ashley Donnelly

• Physical Therapist in Kingston, NY
• Providers in Kingston, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2023; 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.