Kristin Marielle Matthys, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0115671 Issued in NY

Practice address

4279 Crested Butte Run
Syracuse, NY 13215-1355

Phone

(315) 569-9308

Fax

(315) 295-2579

NPI assigned

Jun 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Kristin Marielle Nethercott Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PRN Physical, Occupational and Speech Therapy Network, PLLCGroup PAC ID 5092730788, 84 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• PRN Physical, Occupational and Speech Therapy Network, PLLC

  • Physical Therapist
  • East Greenbush, NY
  • NPI 1336185263
  Medicare reassignment Care Compare group
• Home Stretch Physical Therapy , P.C.

  • Physical Therapist
  • Syracuse, NY
  • NPI 1326483785
  Medicare reassignment NPD
• Mary Lou Corcoran PT, P.C.

  • Physical Therapy Clinic/Center
  • East Syracuse, NY
  • NPI 1699780338
  NPD (past)

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1922034404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PALMER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661242",
            "telephone_number": "315-637-4747",
            "fax_number": "315-637-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4279 CRESTED BUTTE RUN",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132151355",
            "telephone_number": "315-569-9308",
            "fax_number": "315-295-2579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Towne Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NY",
            "postal_code": "130661331",
            "country_code": "US",
            "telephone_number": "315-637-4747",
            "fax_number": "315-637-6711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTHYS",
        "first_name": "KRISTIN",
        "middle_name": "MARIELLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0115671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNOW NY",
            "identifier": "000921740001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5056028",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "435174",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSCNY",
            "identifier": "000135080",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "161303109",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "AA1220",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "161303109",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "NETHERCOTT",
            "middle_name": "MARIELLE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christine Matteson, LCAT, LMHC
• Patricia Matteson, LMSW
• Matthews DDS PC
• Tynesia Matthews, CHHA
• Constance T Matthys
• Michael David Mattiacio, D.D.S.
• Luis M Maturana, M.D.
• Julie Christine Matyasik
• Catherine McMorris Maum, PA-C
• Michael J Maurer, MSW

• Physical Therapist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.