Individual provider Active NPI

Matthew Peter Herman Osborn, DPT

  • Physical Therapist
  • Saint Augustine, FL
National Provider Identifier
1639054893
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT43477 Issued in FL
Practice address
630 E Twincourt TRL Ste 110
Saint Augustine, FL 32095-9113
Phone
(203) 464-9761
NPI assigned
Aug 7, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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 PT43477 FL Primary

Addresses

Primary practice location

630 E Twincourt TRL Ste 110
Saint Augustine, FL 32095-9113

Mailing address

11225 Ardencroft Dr S
Jacksonville, FL 32246-0568
Phone (352) 697-0533

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260617001215 FL Practitioner - Physical Therapist in Private Practice 1153893565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Solutions of Pensacola, LLCGroup PAC ID 7517102973, 32 clinicians

Practice addresses (Care Compare)

115 Bartram Oaks Walk
Suite 101
Saint Johns, FL 32259-3247
Phone (678) 459-3758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT43477FLMDPhysical Therapist

Organizations & group practices 1

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": "1754524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1639054893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11225 ARDENCROFT DR S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322460568",
            "telephone_number": "352-697-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E TWINCOURT TRL STE 110",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320959113",
            "telephone_number": "203-464-9761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORN",
        "first_name": "MATTHEW",
        "middle_name": "PETER HERMAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT43477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.