Individual provider Active NPI

Mikayla Matos, DPT

  • Physical Therapist
  • Pawtucket, RI
National Provider Identifier
1255258455
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT04142 Issued in RI
Practice address
21 Division St
Pawtucket, RI 02860-5352
Phone
(401) 226-0545
Fax
(401) 721-5214
NPI assigned
Jun 30, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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 PT04142 RI Primary

Addresses

Primary practice location

21 Division St
Pawtucket, RI 02860-5352

Mailing address

4 Richmond SQ
Providence, RI 02906-5117
Phone (401) 433-4172

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

25 Orchards Rd
Wolfeboro, NH 03894-4428

4 Richmond SQ
Providence, RI 02906-5137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Jun 30, 2026 Accepting new patients
Silver Fern Practice, LLC Physical Therapist PastSince Jun 30, 2026 Accepting new patients

Locations

545 Pawtucket Ave
Unit 115
Pawtucket, RI 02860
Phone (401) 475-5775

21 Division St
Pawtucket, RI 02860

4 Richmond Sq
Providence, RI 02906
Phone (401) 885-2821

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": "1782777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1255258455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RICHMOND SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065117",
            "telephone_number": "401-433-4172",
            "fax_number": "401-433-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 DIVISION ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605352",
            "telephone_number": "401-226-0545",
            "fax_number": "401-721-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS",
        "first_name": "MIKAYLA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-30",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT04142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.