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

Last updated

Oct 1, 2021By the provider in NPPES

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

State licenses

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

• Athletico LTD

  dba Athletico Physical Therapy

  • 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": []
}

• Iha Health Services Corporation (IHA Hamburg Primary Care)
• Alyssa Kelsey, PT
• Kensington Valley Orthotic & Sports Services
• Jacquelin Kay Kilburn, OT
• 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.

• Physical Therapist in Hamburg, MI
• Providers in Hamburg, MI by specialty
• 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.