Individual provider Active NPI

Matthew Mathis, LMT

  • Massage Therapist
  • Honolulu, HI
National Provider Identifier
1477143683
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MAT-15954 Issued in HI
Practice address
5722 Kalanianaole Hwy
Honolulu, HI 96821-2388
Phone
(808) 489-8897
NPI assigned
Jan 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MAT-15954 HI Primary

Addresses

Primary practice location

5722 Kalanianaole Hwy
Honolulu, HI 96821-2388

Mailing address

5722 Kalanianaole Hwy
Honolulu, HI 96821-2388
Phone (808) 489-8897

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

State licenses

LicenseStateTypeSpecialty
MAT-15954HIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosport Physical Therapy CurrentSince Jan 31, 2021 Accepting new patients

Locations

5722 Kalanianaole Hwy
Honolulu, HI 96821
Phone (808) 373-1114

Organizations & group practices 1

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": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1477143683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5722 KALANIANAOLE HWY",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968212388",
            "telephone_number": "808-489-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5722 KALANIANAOLE HWY",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968212388",
            "telephone_number": "808-489-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "MATTHEW",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "MAT-15954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.