Matthew A. Mailloux, PT, DPT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305206966 Issued in VA

Practice address

7493 Right Flank Rd Ste 410
Mechanicsville, VA 23116-3846

Phone

(804) 569-7091

Fax

(804) 569-7094

NPI assigned

Jun 23, 2011

Last updated

Apr 27, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.16 of 100Reported as group

Quality

85.78

Promoting interoperability

99

Improvement activities

40

Cost

75.6

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tidewater Physical Therapy, LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1457389595
  Medicare reassignment Care Compare group NPD
• Tidewater Physical Therapy, LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Roanoke, VA
  • NPI 1437664356
  NPD
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1477588986
  NPD
• Physical Therapy of Central Virginia, LLC

  • Physical Therapist
  • Fredericksburg, VA
  • NPI 1730453192
  NPD (past)

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1730475260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69030",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212649030",
            "telephone_number": "757-873-2302",
            "fax_number": "757-873-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7493 RIGHT FLANK RD STE 410",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231163846",
            "telephone_number": "804-569-7091",
            "fax_number": "804-569-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAILLOUX",
        "first_name": "MATTHEW",
        "middle_name": "A.",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS (PHYSICAL THERAPY)",
            "identifier": "225579",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730475260",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer B Mahan, DO
• Katherine Mahon, OTR/L
• Laura Mahoney, LOT
• Sara Maida, PT
• Ludna Maiden
• David William Major, DDS
• Joelle Anne Makon, M.D.
• Wendy E Mallory, NP
• Daniel J Mancini, D.P.T.
• Hannah Mann

• Physical Therapist in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; 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.