Matthew Carl Weissbach, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

06679 Issued in OR

Practice address

735 SW 158TH Ave
Suite 160
Beaverton, OR 97006-4952

Phone

(503) 597-0035

Fax

(503) 726-5490

NPI assigned

Nov 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stratos Group LLCGroup PAC ID 6709155534, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stratos Group LLC

  dba Evolve Physical Therapy

  • Physical Therapy Clinic/Center
  • Sherwood, OR
  • NPI 1003357930

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Aquatherapy, Inc.

  dba Prins Aquatherapy

  • Physical Therapy Clinic/Center
  • Honolulu, HI
  • NPI 1952381022
  NPD (past)
• Orthosport Hawaii, LLC

  • Orthopedic Physical Therapist
  • Honolulu, HI
  • NPI 1619147543
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1811061443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 SW 158TH AVE",
            "address_2": "SUITE 160",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064952",
            "telephone_number": "503-597-0035",
            "fax_number": "503-726-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSBACH",
        "first_name": "MATTHEW",
        "middle_name": "CARL",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "06679",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT 2187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Weeks, LCSW
• Shantel Rayanne Wehde
• Beau C. Weill, MD
• Janet Kathleen Weiser, LMT
• Christina Weiss, PSY.D.
• Juliann Weissman, MS, BCBA, LBA
• Karen Elaine Weitz, LMT
• Janice Weitzer, LMT
• Kara Marie Welborn, OTR/L
• Wellness by Design, LLC

• Physical Therapist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.