Individual provider Active NPI

Matthew Granquist, PT, DPT

  • Orthopedic Physical Therapist
  • Burlington, IA
National Provider Identifier
1154618841
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
004179 Issued in IA
Practice address
3211 Division St Ste 3
Burlington, IA 52601-1692
Phone
(319) 754-7899
NPI assigned
Jul 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 004179 IA Primary
Physical Therapist 225100000X 004179 IA

Addresses

Primary practice location

3211 Division St Ste 3
Burlington, IA 52601-1692

Mailing address

850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111004000081 IA Practitioner - Physical Therapist in Private Practice 6103098702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rock Valley Physical Therapy Center 232 clinicians

Practice addresses (Care Compare)

1700 N Division St
Suite 200
Davenport, IA 52804-3535
Phone (563) 324-2263

Merit-based Incentive Payment System (MIPS)

Final score
22.11 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
73.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004179IAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients

Locations

3211 Division St
Ste 3
Burlington, IA 52601
Phone (319) 754-7899

1700 N Division St
Ste 200
Davenport, IA 52804
Phone (563) 324-2263

2109 Cedarwood Dr
Ste 100
Muscatine, IA 52761
Phone (563) 288-6787

400 Ovesen Dr
Wilton, IA 52778
Phone (563) 732-2121

850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070

Organizations & group practices 5

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1154618841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE STE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070",
            "fax_number": "309-743-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 DIVISION ST STE 3",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526011692",
            "telephone_number": "319-754-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANQUIST",
        "first_name": "MATTHEW",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IA",
            "license": "004179",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "004179",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.