Active NPI
Anthony A De Matteo, PT
- Physical Therapist
- Saratoga Springs, NY
National Provider Identifier
1376648071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5650
- Practice address
- 5 Care Lane
Saratoga Springs, NY 12866-8623 - Phone
- (518) 587-5670
- Fax
- (518) 587-5674
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5650 | NY | Primary |
Addresses
Primary practice location
5 Care Lane
Saratoga Springs, NY 12866-8623
Mailing address
5 Care Lane
Saratoga Springs, NY 12866-8623
Phone (518) 587-5670
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00760485 | Medicaid | NY | |
| 10000470 | Other | NY | CDPHP |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5650 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582070400000",
"number": "1376648071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 CARE LANE",
"city": "SARATOGA SPRINGS",
"state": "NY",
"postal_code": "128668623",
"telephone_number": "518-587-5670",
"fax_number": "518-587-5674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 CARE LANE",
"city": "SARATOGA SPRINGS",
"state": "NY",
"postal_code": "128668623",
"telephone_number": "518-587-5670",
"fax_number": "518-587-5674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE MATTEO",
"first_name": "ANTHONY",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2020-02-19",
"certification_date": "2020-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "5650",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00760485",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "10000470",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saratoga Springs, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.