Individual provider Active NPI

Matthew Dudek, D.P.T.

  • Physical Therapist
  • Warren, NJ
National Provider Identifier
1134598618
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01626200 Issued in NJ
Practice address
76 Stirling Rd Ste 400
Warren, NJ 07059-5778
Phone
(908) 251-5888
Fax
(908) 251-5903
NPI assigned
Sep 15, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 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 40QA01626200 NJ Primary

Addresses

Primary practice location

76 Stirling Rd Ste 400
Warren, NJ 07059-5778

Mailing address

76 Stirling Rd
Ste 400
Warren, NJ 07059-5778
Phone (908) 251-5888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151027002363 NJ Practitioner - Physical Therapist in Private Practice 4880903129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watchung Hills Physical TherapyGroup PAC ID 3678578325, 2 clinicians

Practice addresses (Care Compare)

76 Stirling Rd
Suite 400
Warren, NJ 07059-5778
Phone (908) 419-2064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Watchung Hills Physical Therapy Physical Therapist CurrentSince Sep 8, 2020 Accepting new patients

Locations

76 Stirling Rd
Ste 400
Warren, NJ 07059
Phone (908) 251-5888

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": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1134598618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 STIRLING RD",
            "address_2": "STE 400",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595778",
            "telephone_number": "908-251-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 STIRLING RD STE 400",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595778",
            "telephone_number": "908-251-5888",
            "fax_number": "908-251-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDEK",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-15",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01626200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, NJ

Sources for this page

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