Raymond Francis Mattfeld, P.T., A.T.C
Individual provider Active NPI Orthopedic Physical Therapist · Brightwaters, NY
NPI 1487790689 · NPPES record last updated Feb 14, 2008
Key facts
- NPI
- 1487790689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopedic Physical Therapist 2251X0800X
- License
- 012480-1 (NY)
- Practice address
- 160 Orinoco Dr
Brightwaters, NY 11718-1307 - Phone
- (631) 665-9056
- Fax
- (631) 665-9058
- NPI assigned
- Jan 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
160 Orinoco Dr
Brightwaters, NY 11718-1307
Phone (631) 665-9056
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110503000301 | NY | Practitioner - Physical Therapist in Private Practice | 8820273063 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012480-1 | NY | MD | Orthopedic Physical Therapist |
| 000707-1 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bright Bay Physical Therapy P.C. | Current |
Accepting new patients | |
| Bienetre Medical PC | Past | Accepting new patients |
Locations
160 Orinoco Dr
Brightwaters, NY 11718
Phone (631) 665-9056
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 012480-1 | NY | Yes |
| Athletic Trainer | 2255A2300X | 000707-1 | NY |
Addresses
Primary practice location
160 Orinoco Dr
Brightwaters, NY 11718-1307
Mailing address
160 Orinoco Dr
Brightwaters, NY 11718-1307
Phone (631) 665-9056
Other providers in Brightwaters, NY
- Kathleen Mary Manzolillo
- Michele Maratea
- Thomas Andrew Marchese
- Stephanie Masullo
- Matrix Medical Wound Care PLLC
- Patricia Ann McCarren
- Angela McKelvey
- Medical Qualified Service of Suffolk County New York PLLC
- Christian Montanez
- Joann Muniz Sheets
All providers in Brightwaters, NY · Orthopedic Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.