Matthew D. Ironside, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11174-24 Issued in WI

Practice address

410 Dewey St
Wisconsin Rapids, WI 54495-8080

Phone

(715) 424-8500

Fax

(715) 424-8502

NPI assigned

May 12, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle Performance Therapy LLCGroup PAC ID 4486004801, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pinnacle Performance Therapy LLC

  • Physical Therapist
  • Wisconsin Rapids, WI
  • NPI 1770281305
  Medicare reassignment Care Compare group NPD
• Riverview Hospital Association

  • Skilled Nursing Facility
  • Wisconsin Rapids, WI
  • NPI 1114944543
  NPD (past)
• Roberts & Associates Physical Therapy SC

  • Physical Therapist
  • Wisconsin Rapids, WI
  • NPI 1346342839
  NPD (past)
• Roberts & Associates Physical Therapy SC

  • Physical Therapy Clinic/Center
  • Wisconsin Rapids, WI
  • NPI 1538300306
  NPD (past)

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1326272832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 8080",
            "address_2": "410 DEWEY ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544958080",
            "telephone_number": "715-424-8500",
            "fax_number": "715-424-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 DEWEY ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544958080",
            "telephone_number": "715-424-8500",
            "fax_number": "715-424-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRONSIDE",
        "first_name": "MATTHEW",
        "middle_name": "D.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-12",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11174-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Ironside, P.T.
• Macy Sue Jackan, OTR
• Amy J. Jaeger, DPM
• Jatra LLC
• Lea R.C. Javenkoski, OTR
• Michelle Jenner, RN

• Physical Therapist in Wisconsin Rapids, WI
• Providers in Wisconsin Rapids, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2013; 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.