Individual provider Active NPI

Matthew Vandiver, DPT

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1689040826
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11792 Issued in AZ
Practice address
8275 N Silverbell Rd Ste 113
Tucson, AZ 85743-5307
Phone
(520) 382-8202
Fax
(520) 784-6575
NPI assigned
Aug 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 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 11792 AZ Primary

Addresses

Primary practice location

8275 N Silverbell Rd Ste 113
Tucson, AZ 85743-5307

Mailing address

1055 FM 646 Rd W
Apt 1127
Dickinson, TX 77539-3581
Phone (832) 493-4300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151007001620 AZ Practitioner - Physical Therapist in Private Practice 7719295930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8275 N Silverbell Rd
Suite 113
Tucson, AZ 85743-5307
Phone (520) 784-6570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11792AZMDPhysical 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": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1689040826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 FM 646 RD W",
            "address_2": "APT 1127",
            "city": "DICKINSON",
            "state": "TX",
            "postal_code": "775393581",
            "telephone_number": "832-493-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8275 N SILVERBELL RD STE 113",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857435307",
            "telephone_number": "520-382-8202",
            "fax_number": "520-784-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDIVER",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-11",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "11792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.