Irish Matienzo

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

31353 Issued in FL

Practice address

969 Glazebrook Loop
Orange City, FL 32763-6610

Phone

(419) 944-3670

NPI assigned

Feb 27, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Empowerme Rehabilitation Florida, LLC

  • Multi-Specialty Clinic/Center
  • Stuart, FL
  • NPI 1184257602

  Physical Therapist

  Medicare reassignment NPD
• Fox Rehab PT FL LLC

  • Physical Therapist
  • Orlando, FL
  • NPI 1336719624
  Medicare reassignment NPD
• Legacy Healthcare Services, Inc

  • Physical Therapist
  • Tampa, FL
  • NPI 1336535988
  Medicare reassignment NPD
• Empowerme Rehabilitation Florida, LLC

  • Rehabilitation Clinic/Center
  • The Villages, FL
  • NPI 1477245892
  NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489
  NPD

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1508622556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 GLAZEBROOK LOOP",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327636610",
            "telephone_number": "419-944-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 GLAZEBROOK LOOP",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327636610",
            "telephone_number": "419-944-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIENZO",
        "first_name": "IRISH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "31353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahana Masood, M.D
• Angelina Masselink, PHARMD
• Mark Eugene Mathieson, MD
• Anita K Mathur, MD
• Pradeep Mathur, M.D.
• Claudia Matos, LCSW
• Solimar Mattei-Welch, MSW, LMSW
• Matusik Adult Family Care Home
• Matusik Adult Family Care Home
• Gabriel Kwame Mayerson, DNP

• Physical Therapist in Orange City, FL
• Providers in Orange City, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.