Matthew Koziol, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018441 Issued in MI

Practice address

10020 Professional Center Drive
Hamburg, MI 48139

Phone

(810) 893-7623

Fax

(810) 893-7624

NPI assigned

Sep 15, 2017

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: matthew.koziol.p4@direct.athleticoltd.nextgenshare.com

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.

• Athletico LTD

  • Clinic/Center
  • Hamburg, MI
  • NPI 1861942377

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1578082012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10020 PROFESSIONAL CENTER DRIVE",
            "city": "HAMBURG",
            "state": "MI",
            "postal_code": "48139",
            "telephone_number": "810-893-7623",
            "fax_number": "810-893-7624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZIOL",
        "first_name": "MATTHEW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-15",
        "last_updated": "2021-10-01",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5501018441",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Luci H. Klinkhamer, CCC-SLP
• Livingston Eyecare Associates, LLC
• Amanda McClain
• Michigan Rehabilitation Specialists House Calls, P.C.
• Michigan Rehabilitation Specialists, LLC
• Daniel Quentin Minert, C. O.

• All providers in Hamburg, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.