Individual provider Active NPI

Don Mathew Cantaral, PT, DPT, ACSM-EP

  • Physical Therapist
  • North Wilkesboro, NC
National Provider Identifier
1104593748
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P20716 Issued in NC
Practice address
1915 W Park Dr Ste 102
North Wilkesboro, NC 28659-3777
Phone
(336) 903-9293
NPI assigned
Aug 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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 P20716 NC Primary

Addresses

Primary practice location

1915 W Park Dr Ste 102
North Wilkesboro, NC 28659-3777

Mailing address

1915 W Park Dr Ste 102
North Wilkesboro, NC 28659-3777
Phone (336) 903-9293

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211006000039 NC Practitioner - Physical Therapist in Private Practice 3870991888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Associates of Wilkes LLCGroup PAC ID 7214841899, 4 clinicians

Practice addresses (Care Compare)

1915 W Park Dr
Suite 102
North Wilkesboro, NC 28659-3777
Phone (336) 903-9293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P20716NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Associates of Wilkes LLC Physical Therapist CurrentSince Aug 23, 2021 Accepting new patients

Locations

1915 W Park Dr
Ste 102
North Wilkesboro, NC 28659
Phone (336) 903-9093

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1104593748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 W PARK DR STE 102",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593777",
            "telephone_number": "336-903-9293",
            "fax_number": "336-903-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 W PARK DR STE 102",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593777",
            "telephone_number": "336-903-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTARAL",
        "first_name": "DON",
        "middle_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, ACSM-EP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P20716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wilkesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.