Active NPI
Matthew Thomas Beale, CPO
- Prosthetist
- Boston, MA
National Provider Identifier
1730679234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- Practice address
- 137 Portland St
4TH Floor
Boston, MA 02114 - Phone
- (617) 996-9058
- NPI assigned
- May 10, 2018
- Last updated
- Aug 30, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | NU | ||
| Prosthetist | 224P00000X | NU | Primary |
Addresses
Primary practice location
137 Portland St
4TH Floor
Boston, MA 02114
Mailing address
1084 N El Camino Real Ste B
#122
Encinitas, CA 92024
Phone (925) 407-6904
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CPO03996 | Other | AMERICAN BOARD FOR CERTIFICATION (ORTHOTICS, PROSTHETICS, PEDORTHICS | |
| OI61292553 | Other | WA | WASHINGTON STATE DEPARTMENT OF HEALTH ORTHOTIST LICENSE |
| PS61292556 | Other | WA | WASHINGTON STATE DEPARTMENT OF HEALTH PROSTHETIST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myomo | Orthotist | Current | Accepting new patients |
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, 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": "1525910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661817600000",
"number": "1730679234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1084 N EL CAMINO REAL STE B",
"address_2": "#122",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "92024",
"telephone_number": "925-407-6904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 PORTLAND ST",
"address_2": "4TH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-996-9058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEALE",
"first_name": "MATTHEW",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "CPO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-10",
"last_updated": "2022-08-30",
"certification_date": "2022-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN BOARD FOR CERTIFICATION (ORTHOTICS, PROSTHETICS, PEDORTHICS",
"identifier": "CPO03996",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH ORTHOTIST LICENSE",
"identifier": "OI61292553",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH PROSTHETIST LICENSE",
"identifier": "PS61292556",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.