Active NPI
Matthew Lee Bennett, DPT
- Physical Therapist
- Minneapolis, MN
National Provider Identifier
1497282529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 3915 Golden Valley Rd
Minneapolis, MN 55422-4249 - Phone
- (612) 775-2499
- NPI assigned
- May 19, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | MN | ||
| Orthopedic Physical Therapist | 2251X0800X | MN | ||
| Physical Therapist | 225100000X | MN | Primary |
Addresses
Primary practice location
3915 Golden Valley Rd
Minneapolis, MN 55422-4249
Mailing address
10845 69TH Ave N
Maple Grove, MN 55369-5520
Phone (763) 370-9081
Other practice location 1
4515 Shoreline Dr
Spring Park, MN 55384-8500
Phone (952) 471-4000
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Past | Accepting new patients | |
| PHS Lake Minnetonka LLC | Past | Accepting new patients |
Interoperability endpoints
- mbennett315026@excellian.direct.allina.com
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1467758813
-
- Skilled Nursing Facility
- Spring Park, MN
- NPI 1184737926
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1497282529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10845 69TH AVE N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553695520",
"telephone_number": "763-370-9081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3915 GOLDEN VALLEY RD",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554224249",
"telephone_number": "612-775-2499"
}
],
"practiceLocations": [
{
"address_1": "4515 Shoreline Dr",
"address_purpose": "LOCATION",
"city": "Spring Park",
"state": "MN",
"postal_code": "553848500",
"country_code": "US",
"telephone_number": "952-471-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BENNETT",
"first_name": "MATTHEW",
"middle_name": "LEE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-19",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "MN",
"license": null,
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MN",
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.