Individual provider Active NPI

Matthew Arthur Genereux, PT, DPT

  • Physical Therapist
  • South Dartmouth, MA
National Provider Identifier
1265199269
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6046 Issued in ME
Practice address
29 Fremont St
South Dartmouth, MA 02748-3806
Phone
(508) 817-6286
NPI assigned
Nov 24, 2021
Last updated
Nov 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5922 NM
Physical Therapist 225100000X PT6046 ME Primary

Addresses

Primary practice location

29 Fremont St
South Dartmouth, MA 02748-3806

Mailing address

29 Fremont St
South Dartmouth, MA 02748-3806
Phone (508) 817-6286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230414002064 CA Practitioner - Physical Therapist in Private Practice 5890180970
I20241002004275 NH Practitioner - Physical Therapist in Private Practice 5890180970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Androscoggin Valley Hospital IncGroup PAC ID 2365350725, 61 clinicians

Practice addresses (Care Compare)

167 Main St
Gorham, NH 03581-1637
Phone (603) 342-5060

Merit-based Incentive Payment System (MIPS)

Final score
90.34 of 100Reported as apm
Quality
69.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT6046MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Androscoggin Valley Hospital Inc CurrentSince Sep 3, 2024 Accepting new patients
Androscoggin Valley Hospital, Inc. CurrentSince Sep 3, 2024 Accepting new patients
Personally Fit Inc Physical Therapist CurrentSince Apr 12, 2023 Accepting new patients

Locations

11610 Iberia Pl
Ste 100
San Diego, CA 92128
Phone (858) 485-6706

59 Page Hill Rd
Berlin, NH 03570
Phone (603) 752-2200

167 Main St
Gorham, NH 03581
Phone (603) 342-5060

Organizations & group practices 3

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": "1637712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1265199269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 FREMONT ST",
            "city": "SOUTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027483806",
            "telephone_number": "508-817-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 FREMONT ST",
            "city": "SOUTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027483806",
            "telephone_number": "508-817-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENEREUX",
        "first_name": "MATTHEW",
        "middle_name": "ARTHUR",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-24",
        "last_updated": "2021-11-24",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "PT5922",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT6046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Dartmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.