Individual provider Active NPI

Matthew Martinez, PT, DPT

  • Physical Therapist
  • Hyde Park, MA
National Provider Identifier
1851809610
Registry record updated Jan 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22485 Issued in MA
Practice address
60 Harvard Ave
Hyde Park, MA 02136-2815
Phone
(617) 433-8482
NPI assigned
Jan 15, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2024

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 22485 MA Primary

Addresses

Primary practice location

60 Harvard Ave
Hyde Park, MA 02136-2815

Mailing address

60 Harvard Ave
Hyde Park, MA 02136-2815
Phone (210) 313-1974

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180127000005 MA Practitioner - Physical Therapist in Private Practice 7012277734 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22485MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Ventures Physical Therapy, Inc. Physical Therapist CurrentSince Oct 16, 2023 Accepting new patients
Kennedy Brothers Physical Therapy Inc. Physical Therapist CurrentSince Jan 29, 2018 Accepting new patients
Joint Ventures Physical Therapy, Inc. CurrentSince Oct 16, 2023 Accepting new patients
Massachusetts Luna Care Physical Therapy LLC Physical Therapist CurrentSince Sep 21, 2023 Accepting new patients
Kennedy Brothers Physical Therapy Inc. Physical Therapist Past Accepting new patients

Locations

10 Post Office Sq
Ste 800
Boston, MA 02109
Phone (617) 231-0011

533 Commonwealth Ave
Ste 1
Boston, MA 02215

25 Braintree Hill Park
Ofc P
Braintree, MA 02184
Phone (781) 444-1614

15 Oak St
Ste 1
Needham, MA 02492
Phone (781) 444-1614

311 Arsenal St
Watertown, MA 02472
Phone (617) 924-5100

Organizations & group practices 5

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": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705708800000",
    "number": "1851809610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 HARVARD AVE",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021362815",
            "telephone_number": "210-313-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HARVARD AVE",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021362815",
            "telephone_number": "617-433-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MATTHEW",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-15",
        "last_updated": "2024-01-20",
        "certification_date": "2024-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyde Park, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.