Individual provider Active NPI

Matthew Charles Patton, OTR

  • Occupational Therapist
  • Brookfield, WI
National Provider Identifier
1871156653
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6503-26 Issued in WI
Practice address
3415 N 127TH St
Brookfield, WI 53005-3117
Phone
(262) 781-8144
Fax
(262) 781-8552
NPI assigned
Apr 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6503-26 WI Primary

Addresses

Primary practice location

3415 N 127TH St
Brookfield, WI 53005-3117

Mailing address

3415 N 127TH St
Brookfield, WI 53005-3117
Phone (262) 781-8144

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190724000586 WI Practitioner - Occupational Therapist in Private Practice 4880920248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Injury Rehabilitation Clinic II, Inc.Group PAC ID 3072412352, 4 clinicians

Practice addresses (Care Compare)

3415 N 127TH St
Suite 4
Brookfield, WI 53005-3117
Phone (262) 781-8144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Injury Rehabilitation Clinic II, Inc. Occupational Therapist CurrentSince Jun 15, 2019 Accepting new patients

Locations

3415 N 127th St
Brookfield, WI 53005
Phone (262) 781-8144

3415 N 127th St
Ste 4
Brookfield, WI 53005
Phone (262) 781-8144

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": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1871156653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 N 127TH ST",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053117",
            "telephone_number": "262-781-8144",
            "fax_number": "262-781-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 N 127TH ST",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053117",
            "telephone_number": "262-781-8144",
            "fax_number": "262-781-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTON",
        "first_name": "MATTHEW",
        "middle_name": "CHARLES",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6503-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; 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.