Matthew Robert Kresge, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12608953-2401 Issued in UT

Practice address

250 W 300 N
Roosevelt, UT 84066-2336

Phone

(801) 874-5973

NPI assigned

Feb 15, 2022

Last updated

Feb 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uintah Basin Medical CenterGroup PAC ID 0244131944, 62 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.

• Uintah Basin Medical Center

  • General Acute Care Hospital
  • Roosevelt, UT
  • NPI 1871556217
  Medicare reassignment Care Compare group NPD
• Uintah Basin Medical Center

  dba Uintah Basin Healthcare Vernal Pharmacy

  • Community/Retail Pharmacy
  • Vernal, UT
  • NPI 1285420414
  NPD

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

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1871248153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 300 N",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662336",
            "telephone_number": "801-874-5973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W 300 N",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662336",
            "telephone_number": "801-874-5973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRESGE",
        "first_name": "MATTHEW",
        "middle_name": "ROBERT",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12608953-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Killian
• Michiel R. Knight, D.D.S.
• Steven R Knight, CRNA
• Jason Kowallis, OD
• Scott H Kowallis, O.D.
• Sydnee Kunz
• Brett C Larsen, PA
• Jason Jerry Larson, M.D.
• George Scott Laub
• Leading Edge Chiropractic, Inc

• Physical Therapist in Roosevelt, UT
• Providers in Roosevelt, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.