Active NPI
Matthew D Heintzelman, PT, DPT
- Physical Therapist
- Berwyn, PA
National Provider Identifier
1245503309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- DAPT002430
- Practice address
- 607 Midland Cir
Berwyn, PA 19312-1703 - Phone
- (610) 331-5274
- NPI assigned
- Feb 20, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT007104L | PA | |
| Physical Therapist | 225100000X | DAPT002430 | PA | Primary |
Addresses
Primary practice location
607 Midland Cir
Berwyn, PA 19312-1703
Mailing address
607 Midland Cir
Berwyn, PA 19312-1703
Phone (610) 331-5274
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DAPT002430 | PA | MD | Physical Therapist |
| PT007104L | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523491200000",
"number": "1245503309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 MIDLAND CIR",
"city": "BERWYN",
"state": "PA",
"postal_code": "193121703",
"telephone_number": "610-331-5274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 MIDLAND CIR",
"city": "BERWYN",
"state": "PA",
"postal_code": "193121703",
"telephone_number": "610-331-5274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEINTZELMAN",
"first_name": "MATTHEW",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-20",
"last_updated": "2018-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT007104L",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "DAPT002430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berwyn, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.