Individual provider Active NPI

Matthew Cabrera

  • Physical Therapy Assistant
  • Amityville, NY
National Provider Identifier
1417840448
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
012557 Issued in NY
Practice address
11 Broadway
Amityville, NY 11701-2701
Phone
(631) 691-6900
NPI assigned
May 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 012557 NY Primary

Addresses

Primary practice location

11 Broadway
Amityville, NY 11701-2701

Mailing address

1664 August Rd
North Babylon, NY 11703-1928
Phone (516) 220-7889

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

Practice roles

OrganizationSpecialtyStatusNew patients
PKL Physical Therapy & Wellness, PC CurrentSince Jun 3, 2025 Accepting new patients
Jeffrey Wheeler DO PC CurrentSince Jun 3, 2025 Accepting new patients

Locations

11 Broadway
Amityville, NY 11701
Phone (516) 605-1700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1417840448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 AUGUST RD",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117031928",
            "telephone_number": "516-220-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012701",
            "telephone_number": "631-691-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "012557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.