Individual provider Active NPI

Anton Matveev

  • Physical Medicine & Rehabilitation Physician
  • Alexandria, VA
National Provider Identifier
1356879092
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0101275750 Issued in VA
Practice address
1737 King St Ste 110
Alexandria, VA 22314-2727
Phone
(240) 754-7954
NPI assigned
May 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X D94668 MD
Physical Medicine & Rehabilitation Physician 208100000X 0101275750 VA Primary

Addresses

Primary practice location

1737 King St Ste 110
Alexandria, VA 22314-2727

Mailing address

1737 King St Ste 110
Alexandria, VA 22314-2727

Other practice location 1

601 Post Office Rd Ste 2A
Waldorf, MD 20602-1912
Phone (240) 754-7954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230126002699 MD Practitioner - Physical Medicine and Rehabilitation 6305192451 Reassigns benefits to 1 organization
I20230126003338 DC Practitioner - Physical Medicine and Rehabilitation 6305192451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Rutgers New Jersey Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Sports and Regenerative Orthopedics LLCGroup PAC ID 9931327038, 2 clinicians

Practice addresses (Care Compare)

1737 King St
Suite 110
Alexandria, VA 22314-2727
Phone (240) 754-9754

601 Post Office Rd
Suite 2a
Waldorf, MD 20602-1912
Phone (240) 754-7954

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D94668MDMDPhysical Medicine & Rehabilitation Physician
HS000239LPAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Sports and Regenerative Orthopedics, LLC CurrentSince Oct 15, 2022 Accepting new patients

Locations

601 Post Office Rd
Ste 2A
Waldorf, MD 20602
Phone (240) 754-7954

1737 King St
Ste 110
Alexandria, VA 22314
Phone (240) 754-9754

Interoperability endpoints

  • Direct secure messaging: anton.matveev.1@8201.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8201/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1356879092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 KING ST STE 110",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 KING ST STE 110",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142727",
            "telephone_number": "240-754-7954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Post Office Rd Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206021912",
            "country_code": "US",
            "telephone_number": "240-754-7954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATVEEV",
        "first_name": "ANTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-25",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "D94668",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101275750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.