Matthew J Moore, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12501-24 Issued in WI

Practice address

225000 Hummingbird Rd
Ste 100
Wausau, WI 54401-6312

Phone

(715) 359-6442

Fax

(715) 393-0390

NPI assigned

Aug 5, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1457783136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225000 HUMMINGBIRD RD",
            "address_2": "STE 100",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544016312",
            "telephone_number": "715-359-6442",
            "fax_number": "715-393-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225000 HUMMINGBIRD RD",
            "address_2": "STE 100",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544016312",
            "telephone_number": "715-359-6442",
            "fax_number": "715-393-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-05",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12501",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12501-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Monk, MS LPC
• Anthony George Montagna, D.D.S.
• Alexandra Montgomery, PSYD
• Michele H Montgomery, MD
• Dana Moore, LMFT-IT
• Emilee Mootz, RN, BSN
• Sydney Elizabeth Mootz, PA-C
• Samantha Marie Morache, DPT
• Timothy John Moran, M.D.
• Patrick Robert Morath Sr., DDS

• Physical Therapist in Wausau, WI
• Providers in Wausau, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.