Individual provider Active NPI

Matthew James Stuart, PT

  • Physical Therapist
  • Ellicott City, MD
National Provider Identifier
1205859162
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21403 Issued in MD
Practice address
9171 Baltimore National Pike
Ste 120
Ellicott City, MD 21042-3922
Phone
(410) 480-3705
Fax
(410) 480-3707
NPI assigned
Jul 25, 2006
Last updated
Feb 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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 21403 MD Primary

Addresses

Primary practice location

9171 Baltimore National Pike
Ste 120
Ellicott City, MD 21042-3922

Mailing address

9171 Baltimore National Pike
Ste 120
Ellicott City, MD 21042-3922
Phone (410) 480-3705

Other identifiers 2

IdentifierTypeStateIssuer
65089103OtherMDCAREFIRST
J9660004OtherBLUECHOICE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180604000456 NY Practitioner - Physical Therapist in Private Practice 8527161918 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21403MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stern at Home Physical Therapy PC Physical Therapist CurrentSince Feb 19, 2025 Accepting new patients

Locations

4 Medical Park Dr
Ste B
Pomona, NY 10970
Phone (845) 354-3131

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1205859162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9171 BALTIMORE NATIONAL PIKE",
            "address_2": "STE 120",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423922",
            "telephone_number": "410-480-3705",
            "fax_number": "410-480-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9171 BALTIMORE NATIONAL PIKE",
            "address_2": "STE 120",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423922",
            "telephone_number": "410-480-3705",
            "fax_number": "410-480-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "21403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "65089103",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHOICE",
            "identifier": "J9660004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.