Individual provider Active NPI

Matthew James Filla II, MPT

  • Physical Therapist
  • Saint Charles, MO
National Provider Identifier
1710290408
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2006038717 Issued in MO
Practice address
1475 Kisker Rd
Suite 150
Saint Charles, MO 63304-8781
Phone
(636) 498-7474
Fax
(636) 498-7475
NPI assigned
Jul 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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 2006038717 MO Primary

Addresses

Primary practice location

1475 Kisker Rd
Suite 150
Saint Charles, MO 63304-8781

Mailing address

1475 Kisker Rd
Suite 150
Saint Charles, MO 63304-8781
Phone (636) 498-7474

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240605002034 MO Practitioner - Physical Therapist in Private Practice 2961944939 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2006038717MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Rehabilitation LLC Physical Therapist CurrentSince May 1, 2024 Accepting new patients

Locations

12400 Olive Blvd
Ste 425
Saint Louis, MO 63141
Phone (314) 275-9000

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": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1710290408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 KISKER RD",
            "address_2": "SUITE 150",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633048781",
            "telephone_number": "636-498-7474",
            "fax_number": "636-498-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 KISKER RD",
            "address_2": "SUITE 150",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633048781",
            "telephone_number": "636-498-7474",
            "fax_number": "636-498-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLA",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2006038717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.