Individual provider Active NPI

Michael J Matrisciano, PT, DPT

  • Physical Therapist
  • Cherry Hill, NJ
National Provider Identifier
1649922295
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02073200 Issued in NJ
Practice address
1873 Route 70 E Ste 1-J
Cherry Hill, NJ 08003-2034
Phone
(856) 428-4030
Fax
(856) 428-1093
NPI assigned
Jan 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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 40QA02073200 NJ Primary

Addresses

Primary practice location

1873 Route 70 E Ste 1-J
Cherry Hill, NJ 08003-2034

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (888) 830-4125

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220218001444 NJ Practitioner - Physical Therapist in Private Practice 4880088723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

254 Newark Ave
Jersey City, NJ 07302-2633
Phone (551) 222-4396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc Physical Therapist CurrentSince Feb 28, 2022 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Feb 28, 2022 Accepting new patients
Ivyrehab Network Inc. Physical Therapist Current Accepting new patients

Locations

1873 Route 70 E
Ste 1-J
Cherry Hill, NJ 08003
Phone (856) 428-4030

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

254 Newark Ave
Jersey City, NJ 07302
Phone (551) 222-4396

63 Route 70 E
Marlton, NJ 08053
Phone (609) 748-5490

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

Organizations & group practices 3

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": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1649922295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "888-830-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1873 ROUTE 70 E STE 1-J",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032034",
            "telephone_number": "856-428-4030",
            "fax_number": "856-428-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATRISCIANO",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02073200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.