Individual provider Active NPI

Matthew Christopher Watson, PT, DPT, ATC

  • Physical Therapist
  • Dorchester, MA
National Provider Identifier
1881284776
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL27812 Issued in MA
Practice address
960 Morrissey Blvd
Dorchester, MA 02122-3242
Phone
(617) 506-7210
NPI assigned
Jan 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X PTL27812 MA Primary

Addresses

Primary practice location

960 Morrissey Blvd
Dorchester, MA 02122-3242

Mailing address

960 Morrissey Blvd
Dorchester, MA 02122-3242
Phone (617) 506-7210

Other practice location 1

453 Grove St
Morgantown, WV 26505-4706
Phone (304) 692-6310

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240911003854 MA Practitioner - Physical Therapist in Private Practice 5698215036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliott Physical Therapy, IncGroup PAC ID 9830322585, 60 clinicians

Practice addresses (Care Compare)

960 William T Morrissey Blvd
Dorchester, MA 02122-3206
Phone (617) 688-3332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL27812MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elliott Physical Therapy, Inc. Physical Therapist CurrentSince Aug 13, 2024 Accepting new patients

Locations

960 William T Morrissey Blvd
Dorchester, MA 02122
Phone (617) 506-7210

475 Adams St
Milton, MA 02186
Phone (617) 364-4380

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": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1881284776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MORRISSEY BLVD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223242",
            "telephone_number": "617-506-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 MORRISSEY BLVD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223242",
            "telephone_number": "617-506-7210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "453 Grove St",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265054706",
            "country_code": "US",
            "telephone_number": "304-692-6310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "MATTHEW",
        "middle_name": "CHRISTOPHER",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL27812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

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