Individual provider Active NPI

Trevor Matelski

  • Physical Therapist
  • Petoskey, MI
National Provider Identifier
1902205354
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2230 E Mitchell Rd
Suite B
Petoskey, MI 49770-6601
Phone
(231) 348-1011
NPI assigned
Aug 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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 Primary

Addresses

Primary practice location

2230 E Mitchell Rd
Suite B
Petoskey, MI 49770-6601

Mailing address

3975 Brown Rd
Boyne Falls, MI 49713
Phone (231) 330-3531

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141020002393 MI Practitioner - Physical Therapist in Private Practice 3577784362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2230 E Mitchell Rd
Suite B
Petoskey, MI 49770-6601
Phone (231) 348-1011

Merit-based Incentive Payment System (MIPS)

Final score
90.95 of 100Reported as group
Quality
94.34
Improvement activities
40
Cost
77.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosport Physical Therapy and Athletic Rehabilitation Inc. Physical Therapist CurrentSince Aug 25, 2014 Accepting new patients

Locations

930 State St
Ste 10
Harbor Springs, MI 49740
Phone (231) 242-0791

351 S Straits Hwy
Indian River, MI 49749
Phone (231) 238-2302

2230 E Mitchell Rd
Ste B
Petoskey, MI 49770
Phone (231) 348-1011

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": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1902205354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 BROWN RD",
            "city": "BOYNE FALLS",
            "state": "MI",
            "postal_code": "49713",
            "telephone_number": "231-330-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 E MITCHELL RD",
            "address_2": "SUITE B",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497706601",
            "telephone_number": "231-348-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATELSKI",
        "first_name": "TREVOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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.