Individual provider Active NPI

Matthew Kilburn, P.T.

  • Physical Therapist
  • Williamsville, NY
National Provider Identifier
1235538471
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
037824 Issued in NY
Practice address
400 International Dr
Williamsville, NY 14221-5771
Phone
(716) 631-3555
Fax
(716) 631-9525
NPI assigned
Aug 13, 2014
Last updated
Aug 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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 037824 NY Primary

Addresses

Primary practice location

400 International Dr
Williamsville, NY 14221-5771

Mailing address

400 International Dr
Williamsville, NY 14221-5771
Phone (716) 631-3555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1235538471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215771",
            "telephone_number": "716-631-3555",
            "fax_number": "716-631-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215771",
            "telephone_number": "716-631-3555",
            "fax_number": "716-631-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILBURN",
        "first_name": "MATTHEW",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.