Individual provider Active NPI

Matthew Ryan Weiss, DPT

  • Orthopedic Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1417380320
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
12340 Issued in CO
Practice address
155 Printers Pkwy
#125
Colorado Springs, CO 80910-6100
Phone
(719) 635-8622
NPI assigned
Aug 14, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 12340 CO Primary

Addresses

Primary practice location

155 Printers Pkwy
#125
Colorado Springs, CO 80910-6100

Mailing address

14518 Pheasant LN
Homer Glen, IL 60491-9290
Phone (708) 497-5137

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

LicenseStateTypeSpecialty
12340COMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy of Colorado Springs LP PastSince Aug 2, 2020 Accepting new patients
Select Physical Therapy of Colorado Springs LP Past Accepting new patients

Organizations & group practices 2

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": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1417380320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14518 PHEASANT LN",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604919290",
            "telephone_number": "708-497-5137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 PRINTERS PKWY",
            "address_2": "#125",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809106100",
            "telephone_number": "719-635-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-14",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "12340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; 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.