Active NPI
Anna Matkovic, BS
- Physical Therapist
- New York, NY
National Provider Identifier
1386791085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 024129-1
- Practice address
- 1901 1St Ave
New York, NY 10029-7404 - Phone
- (212) 423-8058
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 024129-1 | NY | Primary |
Addresses
Primary practice location
1901 1St Ave
New York, NY 10029-7404
Mailing address
404 Woodward Ave
Ridgewood, NY 11385-1550
Phone (718) 381-7008
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024129-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386791085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 WOODWARD AVE",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113851550",
"telephone_number": "718-381-7008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100297404",
"telephone_number": "212-423-8058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATKOVIC",
"first_name": "ANNA",
"credential": "BS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "024129-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.