Individual provider Active NPI

Matthew Terry Wasland, DPT

  • Physical Therapist
  • Duluth, MN
National Provider Identifier
1598204810
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10573 Issued in MN
Practice address
530 E 2ND St
Essentia Health Polinsky Medical Rehabilitation
Duluth, MN 55805-1913
Phone
(218) 786-5360
NPI assigned
Feb 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10573 MN Primary

Addresses

Primary practice location

530 E 2ND St
Essentia Health Polinsky Medical Rehabilitation
Duluth, MN 55805-1913

Mailing address

400 E 3Rd St
Essentia Health Duluth Clinic McL2Cred
Duluth, MN 55805-1951
Phone (218) 786-3146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200930001982 MN Practitioner - Physical Therapist in Private Practice 1355760091 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
The Duluth Clinic LTD CurrentSince Aug 25, 2020 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Aug 25, 2020 Accepting new patients
Duluth Graduate Medical Education Council Inc Past Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

1502 London Rd
Ste 102
Duluth, MN 55812
Phone (218) 576-0100

400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319

530 E 2nd St
Duluth, MN 55805
Phone (218) 786-5300

4621 E Superior St
Duluth, MN 55804
Phone (218) 786-3550

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

1542 Golf Course Rd
Ste 204
Grand Rapids, MN 55744
Phone (218) 322-4900

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1598204810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC MCL2CRED",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E 2ND ST",
            "address_2": "ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051913",
            "telephone_number": "218-786-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASLAND",
        "first_name": "MATTHEW",
        "middle_name": "TERRY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.