Matthew James Wieclaw, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

052465 Issued in NY

Practice address

8324 Oswego Rd Ste a
Liverpool, NY 13090-1086

Phone

(315) 418-4128

NPI assigned

Jul 24, 2024

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

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Syracuse Orthopedic Specialists, PLLCGroup PAC ID 6406760073, 115 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Syracuse Orthopedic Specialists, PLLC

  • Orthopaedic Surgery Physician
  • Syracuse, NY
  • NPI 1669410379
  Medicare reassignment Care Compare group NPD
• Syracuse Orthopedic Specialists, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Liverpool, NY
  • NPI 1689953135
  NPD (past)

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1770311433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5786 WIDEWATERS PKWY STE 2",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141840",
            "telephone_number": "315-418-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8324 OSWEGO RD STE A",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901086",
            "telephone_number": "315-418-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIECLAW",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "052465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene West, DDS,MS
• Westside Podiatry Center LLP
• Thomasina White, CASAC
• Samantha Whittemore, RN
• Catherine Ann Widrick, RPH
• Connie Wierzbicki, CASAC
• Emily Sarah Wilgocki, PA-C
• Ericka Williams, RN
• Kaiden Williams
• La'Shawna Therese Williams, LICENSED LPN

• Physical Therapist in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.