Matthew Detore, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA0Q1559200 Issued in NJ

Practice address

6595 Roosevelt Blvd
B
Philadelphia, PA 19149-2918

Phone

(215) 743-2332

Fax

(215) 743-2330

NPI assigned

Dec 9, 2009

Last updated

Apr 14, 2026By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rehabclinics SPT Inc.

  • Physical Therapy Clinic/Center
  • Little Egg Harbor, NJ
  • NPI 1699113688
  Medicare reassignment
• Rehabclinics SPT, Inc.

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Chalfont, PA
  • NPI 1952009482
  NPD
• Rehabclinics SPT Inc

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Moorestown, NJ
  • NPI 1346246824
  NPD
• Rehabclinics SPT Inc

  dba Novacare Rehabilitation

  • Physical Therapy Clinic/Center
  • Manahawkin, NJ
  • NPI 1043271216
  NPD (past)

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1538498217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6595 ROOSEVELT BLVD",
            "address_2": "B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492918",
            "telephone_number": "215-743-2332",
            "fax_number": "215-743-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6595 ROOSEVELT BLVD",
            "address_2": "B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492918",
            "telephone_number": "215-743-2332",
            "fax_number": "215-743-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETORE",
        "first_name": "MATTHEW",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-09",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT022243",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA0Q1559200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiny Ife Inc
• Destiny Pharmacy of America Inc. (Destiny Pharmacy)
• Destiny's Gift
• Gladys Desvarieux
• Detention Management Solutions
• John Alan Detre, MD
• Mercedes Julia Dettra, PMHNP
• Monika Erlinde Deturk, CRNP
• Amanda Detweiler, LPC
• Karen Detweiler, ANP-BC

• Physical Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.