Individual provider Active NPI

Matthew Ian Seltzer, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1780082644
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
038508-1 Issued in NY
Practice address
1384 Broadway Ste 606
New York, NY 10018-6108
Phone
(631) 896-3821
NPI assigned
Dec 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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 038508-1 NY Primary

Addresses

Primary practice location

1384 Broadway Ste 606
New York, NY 10018-6108

Mailing address

2516 30TH Dr Apt 2F
Astoria, NY 11102-2733
Phone (631) 896-3821

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150409001804 NY Practitioner - Physical Therapist in Private Practice 7315265063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifestyle Physical Therapy, LLC.Group PAC ID 4880966985, 3 clinicians

Practice addresses (Care Compare)

1384 Broadway
RM 606
New York, NY 10018-6110
Phone (631) 896-3821

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestyle Rehabilitation LLC Physical Therapist CurrentSince Nov 8, 2025 Accepting new patients
Lifestyle Physical Therapy, LLC Physical Therapist CurrentSince Aug 17, 2017 Accepting new patients

Locations

1384 Broadway
Rm 606
New York, NY 10018
Phone (212) 302-0141

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1780082644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 30TH DR APT 2F",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022733",
            "telephone_number": "631-896-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1384 BROADWAY STE 606",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100186108",
            "telephone_number": "631-896-3821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELTZER",
        "first_name": "MATTHEW",
        "middle_name": "IAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-09",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "038508-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.