Individual provider Active NPI

Matthew David Giordanelli, PT, DPT, ATC, CSCS

  • Physical Therapist
  • Fort Collins, CO
National Provider Identifier
1154711398
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15739 Issued in CO
Practice address
3500 JFK Pkwy Ste 120
Fort Collins, CO 80525-2635
Phone
(970) 663-6142
Fax
(970) 488-2850
NPI assigned
Jan 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14228-24 WI
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X 15739 CO Primary

Addresses

Primary practice location

3500 JFK Pkwy Ste 120
Fort Collins, CO 80525-2635

Mailing address

808 Terrace Ave
Kingsford, MI 49802-4224
Phone (906) 396-4352

Other practice location 1

108 S Frontage Rd W
Vail, CO 81657-5053
Phone (970) 479-7291

Other practice location 2

808 Terrace Ave
Kingsford, MI 49802
Phone (906) 396-4352

Other practice location 3

107 W 29th St Ste 100
Loveland, CO 80538-2200
Phone (970) 663-6142 ext. 1

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190911001206 CO Practitioner - Physical Therapist in Private Practice 4486983715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rebound Sports and Physical Therapy P.CGroup PAC ID 0042106098, 21 clinicians

Practice addresses (Care Compare)

1300 Riverside Ave
Suite 100
Fort Collins, CO 80524-4351
Phone 97066361423

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15739COMDPhysical Therapist
14228-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rebound Sports & Physical Therapy, P.C. Physical Therapist CurrentSince May 10, 2021 Accepting new patients
Berkana Rehabilitation, PLLC Physical Therapist CurrentSince Sep 23, 2019 Accepting new patients

Locations

3500 John F Kennedy Pkwy
Ste 120
Fort Collins, CO 80525
Phone (970) 663-6142

1300 Riverside Ave
Ste 100
Fort Collins, CO 80524
Phone (970) 663-6142

2001 S Shields St
Ste A1
Fort Collins, CO 80526
Phone (970) 797-2431

107 W 29th St
Ste 100
Loveland, CO 80538
Phone (970) 663-6142

Organizations & group practices 2

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": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1154711398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 TERRACE AVE",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024224",
            "telephone_number": "906-396-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 JFK PKWY STE 120",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252635",
            "telephone_number": "970-663-6142",
            "fax_number": "970-488-2850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 S Frontage Rd W",
            "address_purpose": "LOCATION",
            "city": "Vail",
            "state": "CO",
            "postal_code": "816575053",
            "country_code": "US",
            "telephone_number": "970-479-7291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "808 Terrace Ave",
            "address_purpose": "LOCATION",
            "city": "Kingsford",
            "state": "MI",
            "postal_code": "49802",
            "country_code": "US",
            "telephone_number": "906-396-4352",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 W 29th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "CO",
            "postal_code": "805382200",
            "country_code": "US",
            "telephone_number": "970-663-6142 x1",
            "fax_number": "970-635-3087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIORDANELLI",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "PT, DPT, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-26",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14228-24",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "15739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.