Active NPI
Matthew Laliberte, PTA
- Physical Therapy Assistant
- New York, NY
National Provider Identifier
1649941147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 010742-1
- Practice address
- 123 W 18TH Street
Cellar
New York, NY 10011 - Phone
- (646) 678-5980
- NPI assigned
- Sep 23, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 010742-1 | NY | Primary |
Addresses
Primary practice location
123 W 18TH Street
Cellar
New York, NY 10011
Mailing address
401 Washington Blvd Apt 2907
Jersey City, NJ 07310-2230
Phone (401) 365-7006
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010742-1 | Other | NY | THE UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010742-1 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632355200000",
"number": "1649941147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 WASHINGTON BLVD APT 2907",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073102230",
"telephone_number": "401-365-7006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 W 18TH STREET",
"address_2": "CELLAR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10011",
"telephone_number": "646-678-5980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LALIBERTE",
"first_name": "MATTHEW",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-23",
"last_updated": "2021-09-23",
"certification_date": "2021-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "010742-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THE UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT",
"identifier": "010742-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.