Matthew John Johnson, PT, DPT, LAT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT029253 Issued in PA

Practice address

27 Whittier Dr
Greenlawn, NY 11740-2609

Phone

(631) 754-6730

NPI assigned

Oct 17, 2014

Last updated

Apr 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EACEAA

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.

• Neurosurgical Care, LLC

  • Durable Medical Equipment & Medical Supplies
  • Collegeville, PA
  • NPI 1265629323
  NPD (past)

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1487058582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4552 MERCER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191371712",
            "telephone_number": "631-965-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 WHITTIER DR",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117402609",
            "telephone_number": "631-754-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "credential": "PT, DPT, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-17",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT007692",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Intuitive Creative Arts Therapy PLLC
• Richard Charles Irace, DPT
• Rami Ismail
• J. Gerald Meagher MD PC
• Rita Jaquez, BSN, RN
• Juliette Julien, LPN
• Christopher A Junker, P.T.
• Cathryn W Karafa, LSP
• Kristen Kelly, PA-C
• Anne E. Kieran, D.O.

• Physical Therapist in Greenlawn, NY
• Providers in Greenlawn, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.