Individual provider Active NPI

Matthew Robertson

  • Physical Therapist
  • Sicklerville, NJ
National Provider Identifier
1730556549
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
542 Berlin Cross Keys Rd
Sicklerville, NJ 08081-4367
Phone
(856) 740-0009
NPI assigned
Aug 27, 2015
Last updated
Aug 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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 NU Primary

Addresses

Primary practice location

542 Berlin Cross Keys Rd
Sicklerville, NJ 08081-4367

Mailing address

61 Hillside Ave
Midland Park, NJ 07432-1721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190307001126 NJ Practitioner - Physical Therapist in Private Practice 9335488402 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
Mile High Physical Therapy Professional CorporationGroup PAC ID 7911257597, 6 clinicians

Practice addresses (Care Compare)

321 Changebridge Rd
Suite 103
Pine Brook, NJ 07058-9584
Phone (973) 396-8585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mile High Physical Therapy Professional Corporation Physical Therapist CurrentSince Jan 28, 2019 Accepting new patients
Personal Best Rehab at Pine Brook, LLC Physical Therapist PastSince Feb 13, 2017 Accepting new patients

Locations

321 Changebridge Rd
Ste 103
Pine Brook, NJ 07058
Phone (973) 396-8585

64 US Highway 46
Pine Brook, NJ 07058
Phone (973) 396-8585

Organizations & group practices 2

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": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1730556549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 HILLSIDE AVE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 BERLIN CROSS KEYS RD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080814367",
            "telephone_number": "856-740-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sicklerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.