Individual provider Active NPI

Matthew Berke, PT

  • Orthopedic Physical Therapist
  • South Jordan, UT
National Provider Identifier
1710467188
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
10844688-8016 Issued in UT
Practice address
5126 W Daybreak Pkwy
South Jordan, UT 84009-5994
Phone
(801) 213-4500
NPI assigned
Aug 15, 2018
Last updated
Dec 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 10844688-8016 UT Primary

Addresses

Primary practice location

5126 W Daybreak Pkwy
South Jordan, UT 84009-5994

Mailing address

1326 E 900 S
Salt Lake City, UT 84105-1618
Phone (925) 963-4351

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mberke305696@direct.med.utah.edu Direct University of Utah

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181205000176 UT Practitioner - Physical Therapist in Private Practice 7012251861 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10844688-8016UTMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Community Physicians Group Current Accepting new patients
University of Utah CurrentSince Aug 27, 2018 Accepting new patients
University of Utah CurrentSince Aug 27, 2018 Accepting new patients

Locations

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

5126 W Daybreak Pkwy
South Jordan, UT 84009
Phone (801) 213-4320

Interoperability endpoints

  • Direct secure messaging: mberke305696@direct.med.utah.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1710467188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 E 900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841051618",
            "telephone_number": "925-963-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5126 W DAYBREAK PKWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840095994",
            "telephone_number": "801-213-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKE",
        "first_name": "MATTHEW",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-15",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "UT",
            "license": "10844688-8016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mberke305696@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.