Individual provider Active NPI

J Matthew Hanling, PT, CERT, MDT

  • Physical Therapist
  • Wilmington, DE
National Provider Identifier
1780687053
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J10000534 Issued in DE
Practice address
5307 Limestone Rd
Suite 203
Wilmington, DE 19808-1268
Phone
(302) 234-8170
Fax
(302) 234-8174
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X J10000534 DE Primary
Physical Therapist 225100000X PT0052927L PA

Addresses

Primary practice location

5307 Limestone Rd
Suite 203
Wilmington, DE 19808-1268

Mailing address

5307 Limestone Road
Suite 203
Wilmington, DE 19808
Phone (302) 234-8170

Other identifiers 3

IdentifierTypeStateIssuer
S53652OtherDEBCBS PROVIDER ID
5707453OtherDEAETNA PROVIDER ID
1000037609MedicaidDE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081031000009 DE Practitioner - Physical Therapist in Private Practice 6800858812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5307 Limestone Rd
Suite 203
Wilmington, DE 19808-1283
Phone (302) 234-8170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
J10000534DEMDPhysical Therapist
PT0052927LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MKL LTD LLC Physical Therapist Past Accepting new patients

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1780687053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5307 LIMESTONE ROAD",
            "address_2": "SUITE 203",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19808",
            "telephone_number": "302-234-8170",
            "fax_number": "302-234-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5307 LIMESTONE RD",
            "address_2": "SUITE 203",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081268",
            "telephone_number": "302-234-8170",
            "fax_number": "302-234-8174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLING",
        "first_name": "J",
        "middle_name": "MATTHEW",
        "credential": "PT, CERT, MDT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J10000534",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT0052927L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "S53652",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "5707453",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000037609",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

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