Individual provider Active NPI

Matthew Richard Breton, PT,MPT,OCS,CSCS

  • Physical Therapist
  • Lyndonville, VT
National Provider Identifier
1629054697
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040.0003564 Issued in VT
Practice address
569 Main St
Lyndonville, VT 05851-9240
Phone
(802) 626-4224
Fax
(802) 626-5042
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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 040.0003564 VT Primary

Addresses

Primary practice location

569 Main St
Lyndonville, VT 05851-9240

Mailing address

PO Box 905
St Johnsbury, VT 05819-0905
Phone (802) 748-8141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120126000543 VT Practitioner - Physical Therapist in Private Practice 4981871290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Vermont Regional Hospital Inc 104 clinicians

Practice addresses (Care Compare)

569 Main St
Lyndonville, VT 05851-9240
Phone (802) 626-4224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040.0003564VTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital Inc Physical Therapist CurrentSince Dec 1, 2018 Accepting new patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Dec 1, 2018 Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients

Locations

1315 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 748-3638

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1629054697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 905",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058190905",
            "telephone_number": "802-748-8141",
            "fax_number": "802-748-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 MAIN ST",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058519240",
            "telephone_number": "802-626-4224",
            "fax_number": "802-626-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETON",
        "first_name": "MATTHEW",
        "middle_name": "RICHARD",
        "credential": "PT,MPT,OCS,CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040.0003564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndonville, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.