Active NPI
Matthew Paul Buch, PT
- Physical Therapist
- De Pere, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14872
- Practice address
- 920 Main Ave Ste B
De Pere, WI 54115-1306 - Phone
- (920) 403-0085
- Fax
- (920) 278-5368
- NPI assigned
- Sep 24, 2019
- Last updated
- Oct 31, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 14872 | WI | Primary |
Addresses
Primary practice location
920 Main Ave Ste B
De Pere, WI 54115-1306
Mailing address
920 Main Ave Ste B
De Pere, WI 54115-1306
Phone (920) 403-0085
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100093827 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14872 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | Physical Therapist | Current | Accepting new patients |
| Oconto Hospital & Medical Center Inc | Current | Accepting new patients | |
| Oconto Hospital & Medical Center Inc | Current | Accepting new patients | |
| Total Pursuit Physical Therapy & Performance | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients |
Locations
920 Main Ave
#B
De Pere, WI 54115
Phone (920) 336-2822
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
575 4th St
Kewaunee, WI 54216
Phone (920) 388-4640
3415 Custer St
Ste D
Manitowoc, WI 54220
Phone (920) 652-9310
2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171
820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapy Clinic/Center
- De Pere, WI
- NPI 1598588329
-
dba Bellin Health
- Family Medicine Physician
- Green Bay, WI
- NPI 1033172390
Physical Therapist
-
dba Bellin Health Algoma
- Rural Health Clinic/Center
- Algoma, WI
- NPI 1609838473
-
dba Bellin Health Suring
- Rural Health Clinic/Center
- Suring, WI
- NPI 1104418037
-
dba Emplify Health Oconto Hospital
- Critical Access Hospital
- Oconto, WI
- NPI 1356373302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1891346672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 MAIN AVE STE B",
"city": "DE PERE",
"state": "WI",
"postal_code": "541151306",
"telephone_number": "920-403-0085",
"fax_number": "920-278-5368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 MAIN AVE STE B",
"city": "DE PERE",
"state": "WI",
"postal_code": "541151306",
"telephone_number": "920-403-0085",
"fax_number": "920-278-5368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCH",
"first_name": "MATTHEW",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-24",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "14872",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100093827",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in De Pere, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.