Individual provider Active NPI

Jennifer Mattei, P.T.

  • Physical Therapist
  • Leonardtown, MD
National Provider Identifier
1407919517
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25069 Issued in CA
Practice address
40900 Merchants LN
Suite 202
Leonardtown, MD 20650-3795
Phone
(301) 997-1155
Fax
(301) 997-1199
NPI assigned
Dec 19, 2006
Last updated
Oct 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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 25069 CA Primary

Addresses

Primary practice location

40900 Merchants LN
Suite 202
Leonardtown, MD 20650-3795

Mailing address

23085 Hollywood Rd
Leonardtown, MD 20650-4734
Phone (301) 475-2060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051022000288 MD Practitioner - Physical Therapist in Private Practice 3678599263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Strickland Physical Therapy, LLCGroup PAC ID 6305920539, 4 clinicians

Practice addresses (Care Compare)

40900 Merchants LN
Unit 202
Leonardtown, MD 20650-3796
Phone (301) 997-1155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19855MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Strickland Physical Therapy, LLC Physical Therapist CurrentSince May 12, 2016 Accepting new patients
Sage Physical Therapy & Wellness LLC Physical Therapist Past Accepting new patients
Gateau Physical Therapy Physical Therapist PastSince Nov 17, 2014 Accepting new patients

Locations

40900 Merchants Ln
Unit 202
Leonardtown, MD 20650
Phone (301) 997-1155

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1407919517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23085 HOLLYWOOD RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206504734",
            "telephone_number": "301-475-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40900 MERCHANTS LN",
            "address_2": "SUITE 202",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503795",
            "telephone_number": "301-997-1155",
            "fax_number": "301-997-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTEI",
        "first_name": "JENNIFER",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "25069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.