Individual provider Active NPI

Christine Ashley Matosian, DPT

  • Physical Therapist
  • Derby, CT
National Provider Identifier
1356769889
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9853 Issued in CT
Practice address
350 Seymour Ave
Derby, CT 06418-1336
Phone
(203) 732-7445
NPI assigned
Apr 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 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 9853 CT Primary

Addresses

Primary practice location

350 Seymour Ave
Derby, CT 06418-1336

Mailing address

10 Hillcrest Ave
Derby, CT 06418-2213
Phone (203) 231-2274

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

LicenseStateTypeSpecialty
9853CTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1356769889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HILLCREST AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182213",
            "telephone_number": "203-231-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SEYMOUR AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181336",
            "telephone_number": "203-732-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOSIAN",
        "first_name": "CHRISTINE",
        "middle_name": "ASHLEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "9853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.