Individual provider Active NPI

Matthew Reynolds, PT, DPT

  • Physical Therapist
  • Waterbury, CT
National Provider Identifier
1871984070
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010395 Issued in CT
Practice address
500 Chase Pkwy FL 1
Waterbury, CT 06708-3346
Phone
(203) 754-2266
Fax
(203) 591-8680
NPI assigned
Feb 10, 2015
Last updated
Nov 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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 010395 CT Primary

Addresses

Primary practice location

500 Chase Pkwy FL 1
Waterbury, CT 06708-3346

Mailing address

1377 Motor Pkwy Ste 307
Islandia, NY 11749-5258
Phone (914) 294-4050

Other practice location 1

145 Hazard Ave
Enfield, CT 06082-4521
Phone (860) 265-2571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010395CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Connecticut, Inc. Physical Therapist CurrentSince Dec 7, 2020 Accepting new patients
Integrated Rehabilitation Services Limited Partnership Physical Therapist CurrentSince Aug 28, 2022 Accepting new patients
Healthfit LLC Current Accepting new patients

Locations

145 Hazard Ave
Enfield, CT 06082
Phone (860) 265-2571

586 Middle Tpke E
Manchester, CT 06040
Phone (860) 645-3810

230 Mountain Rd
Fl 2
Suffield, CT 06078
Phone (860) 668-9589

435 Hartford Tpke
Ste U
Vernon Rockville, CT 06066
Phone (860) 870-8272

101 N Plains Rd
Wallingford, CT 06492
Phone (203) 265-0018

500 Chase Pkwy
Fl 1
Waterbury, CT 06708
Phone (203) 754-2266

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1871984070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "914-294-4050",
            "fax_number": "203-866-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CHASE PKWY FL 1",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083346",
            "telephone_number": "203-754-2266",
            "fax_number": "203-591-8680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Hazard Ave",
            "address_purpose": "LOCATION",
            "city": "Enfield",
            "state": "CT",
            "postal_code": "060824521",
            "country_code": "US",
            "telephone_number": "860-265-2571",
            "fax_number": "860-265-2574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MATTHEW",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-10",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "010395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.