Individual provider Active NPI

Matthew Mark Calabrese, PTA

  • Physical Therapy Assistant
  • Homestead, FL
National Provider Identifier
1801190129
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA18547 Issued in FL
Practice address
2237 SE 26TH LN
Homestead, FL 33035-1353
Phone
(786) 554-0002
NPI assigned
Dec 29, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA18547 FL Primary

Addresses

Primary practice location

2237 SE 26TH LN
Homestead, FL 33035-1353

Mailing address

PO Box 343608
Florida City, FL 33034-0608

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

State licenses

LicenseStateTypeSpecialty
PTA18547FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1801190129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 343608",
            "city": "FLORIDA CITY",
            "state": "FL",
            "postal_code": "330340608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2237 SE 26TH LN",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330351353",
            "telephone_number": "786-554-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALABRESE",
        "first_name": "MATTHEW",
        "middle_name": "MARK",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-29",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA18547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.