Matthew D Fenstermaker, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60266971 Issued in WA

Practice address

1408 Lake Tapps Pkwy SE
Ste E106
Auburn, WA 98092-8158

Phone

(253) 939-7179

Fax

(253) 939-7182

NPI assigned

Apr 9, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lighthouse Physical Therapy and Sports MedicineGroup PAC ID 9032506845, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Lighthouse Physical Therapy and Sports Medicine

  • Physical Medicine & Rehabilitation Physician
  • Greenacres, WA
  • NPI 1598364143

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Outpatient Physical Therapy & Sports Rehabilitation Inc PC

  • Physical Therapist
  • Maple Valley, WA
  • NPI 1730394420
  NPD (past)
• Lighthouse Physical Therapy, LLC

  • Physical Therapist
  • Portsmouth, NH
  • NPI 1568433092
  NPD (past)

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1437415080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 LAKE TAPPS PKWY SE",
            "address_2": "STE E106",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980928158",
            "telephone_number": "253-939-7179",
            "fax_number": "253-939-7182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 LAKE TAPPS PKWY SE",
            "address_2": "STE E106",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980928158",
            "telephone_number": "253-939-7179",
            "fax_number": "253-939-7182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENSTERMAKER",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60266971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Farnsworth, CF-SLP
• Jacob Farren-Davis
• Judith Featherstone
• Erik Anthony Feider, D.D.S.
• Joel Felipe, MD
• Courtney Ferguson, PTA
• Ferlicia Fergusson-Prudent, PSYD, LMHC
• Aiko Fernandez
• Rafael Ferrer Morales
• Tracy Ferry

• Physical Therapist in Auburn, WA
• Providers in Auburn, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.