Individual provider Active NPI

Kaitlyn Matloff

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1609378710
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
044246 Issued in NY
Practice address
200 Patewood Dr Ste C150
Greenville, SC 29615-6323
Phone
(864) 780-4767
Fax
(864) 794-5402
NPI assigned
Mar 5, 2018
Last updated
Mar 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X
Physical Therapist 225100000X SC
Physical Therapist 225100000X 044246 NY Primary

Addresses

Primary practice location

200 Patewood Dr Ste C150
Greenville, SC 29615-6323

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

1250 Waters Pl
Bronx, NY 10461-2720
Phone (347) 810-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181011002162 MA Practitioner - Physical Therapist in Private Practice 5597017921 Reassigns benefits to 1 organization
I20201007000454 SC Practitioner - Physical Therapist in Private Practice 5597017921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenville Proaxis Therapy LLCGroup PAC ID 0244267771, 221 clinicians

Practice addresses (Care Compare)

838 Powdersville Rd
Suite T
Easley, SC 29642-3703
Phone (864) 671-1650

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Quality
90
Improvement activities
40
Cost
75.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greendale Physical Therapy, LLC Physical Therapist CurrentSince Aug 12, 2018 Accepting new patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Sep 21, 2020 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince Sep 21, 2020 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

280 Boston Tpke
Shrewsbury, MA 01545
Phone (508) 753-7780

838 Powdersville Rd
Ste T
Easley, SC 29642
Phone (864) 671-1650

103 N Main St
Greenville, SC 29601
Phone (864) 936-0502

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

2 Doctors Dr
Greenville, SC 29605
Phone (864) 558-8955

200 Patewood Dr
Ste C150
Greenville, SC 29615
Phone (864) 454-0904

2400 N Pleasantburg Dr
Ste D
Greenville, SC 29609
Phone (864) 268-9040

905 Verdae Blvd
Ste 104
Greenville, SC 29607
Phone (864) 522-6100

1305 S Suber Rd
Greer, SC 29650
Phone (864) 989-4609

2127 Old Spartanburg Rd
Greer, SC 29650
Phone (864) 874-6593

2127 Old Spartanburg Rd
Unit A
Greer, SC 29650

315 Medical Pkwy
Ste 150
Greer, SC 29650
Phone (864) 695-1418

2615 Woodruff Rd
Ste 400
Simpsonville, SC 29681
Phone (864) 537-5016

32 Magnolia Cove Dr
#A
Simpsonville, SC 29680
Phone (864) 881-3745

2660 Reidville Rd
Ste 6
Spartanburg, SC 29301
Phone (864) 576-3738

36 S Main St
Ste B
Travelers Rest, SC 29690
Phone (864) 660-8200

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1609378710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE C150",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156323",
            "telephone_number": "864-780-4767",
            "fax_number": "864-794-5402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 Waters Pl",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104612720",
            "country_code": "US",
            "telephone_number": "347-810-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATLOFF",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.