Individual provider Active NPI

Mathew R Henninger, DPT

  • Physical Therapist
  • Carlisle, PA
National Provider Identifier
1811241268
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT022475 Issued in PA
Practice address
311 S West St
Carlisle, PA 17013-3854
Phone
(717) 462-7606
Fax
(717) 458-1559
NPI assigned
Nov 7, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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 PT022475 PA Primary

Addresses

Primary practice location

311 S West St
Carlisle, PA 17013-3854

Mailing address

129 Yates St
Mount Holly Springs, PA 17065-1019
Phone (717) 462-7606

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121228000190 PA Practitioner - Physical Therapist in Private Practice 8426201310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henninger Physical TherapyGroup PAC ID 7911376421, 2 clinicians

Practice addresses (Care Compare)

311 S W St
Carlisle, PA 17013-3854
Phone (717) 462-7606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT022475PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Henninger Physical Therapy Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients

Locations

311 S West St
Carlisle, PA 17013
Phone (717) 448-3409

Organizations & group practices 1

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": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1811241268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 YATES ST",
            "city": "MOUNT HOLLY SPRINGS",
            "state": "PA",
            "postal_code": "170651019",
            "telephone_number": "717-462-7606",
            "fax_number": "717-458-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S WEST ST",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170133854",
            "telephone_number": "717-462-7606",
            "fax_number": "717-458-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNINGER",
        "first_name": "MATHEW",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-07",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT022475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.