Matthew R Miller, PT, DPT
Individual provider Active NPI Physical Therapist · Wall, NJ
NPI 1780775155 · NPPES record last updated Oct 7, 2010
Key facts
- NPI
- 1780775155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 40QA00464800 (NJ)
- Practice address
- 2510 Belmar Blvd
Colfax Plaza
Wall, NJ 07719-3948 - Phone
- (732) 681-1122
- Fax
- (732) 681-0999
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ivyrehab Network Inc
Practice addresses (Care Compare)
167 US
Suite 9
Morganville, NJ 07751
Phone (732) 334-5000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111206000602 | NJ | Practitioner - Physical Therapist in Private Practice | 3274707385 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Network, Inc. | Physical Therapist | Current |
Accepting new patients |
| Ivyrehab Network Inc. | Physical Therapist | Current |
Accepting new patients |
Locations
731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780
454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905
555 S Livingston Ave
Livingston, NJ 07039
Phone (973) 974-9292
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA00464800 | NJ | Yes |
Addresses
Primary practice location
2510 Belmar Blvd
Colfax Plaza
Wall, NJ 07719-3948
Mailing address
PO Box 1703
Wall, NJ 07719
Phone (732) 681-1122
Other providers in Wall, NJ
- Sandra Ann Mead
- Medexpress Urgent Care - New Jersey, Inc
- Sushil K Mehandru
- Catherine L Meli
- Meridian Nursing and Rehabilitation, Inc.
- Gregory Matthew Minnis
- Pamela A Minnis
- Modern Dermatology and Cosmetic Center LLC
- Cindy Monsen-Gorto
- Kim H Morales
All providers in Wall, NJ · Physical Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.