Matthew Cacciatore III, DPT
Individual provider Active NPI Physical Therapist · Great Neck, NY
NPI 1962018291 · NPPES record last updated Sep 22, 2020
Key facts
- NPI
- 1962018291
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 046230 (NY)
- Practice address
- 475 Northern Blvd Ste 11
Great Neck, NY 11021-4802 - Phone
- (516) 829-0030
- Fax
- (516) 466-7723
- NPI assigned
- Sep 22, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Professional Occupational and Physical Therapy, PLLC
Practice addresses (Care Compare)
1 Greenwood Ave
Montclair, NJ 07042-3649
Phone (973) 746-2424
160 Franklin Ave
Nutley, NJ 07110-3075
Phone (973) 667-0429
2142 Utopia Pkwy
Whitestone, NY 11357-4142
Phone (718) 767-0610
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200928002407 | NY | Practitioner - Physical Therapist in Private Practice | 4880013663 | Reassigns benefits to 2 organizations |
| I20250819001979 | NJ | Practitioner - Physical Therapist in Private Practice | 4880013663 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046230 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
| Reddy Care Physical Therapy PC | Single Specialty | Current |
Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Single Specialty | Current |
Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current |
Accepting new patients |
Locations
1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424
524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591
123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248
309 Northwest Dr
Farmingdale, NY 11735
Phone (516) 420-2900
475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023
576 Broadhollow Rd
Melville, NY 11747
27003 Hillside Ave
New Hyde Park, NY 11040
Phone (718) 831-1700
2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 046230 | NY | Yes |
Addresses
Primary practice location
475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Mailing address
475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Phone (516) 829-0030
Other practice location 1
309 Northwest Dr
Farmingdale, NY 11735-4935
Phone (516) 420-2900
Other providers in Great Neck, NY
- Sevda Cabas
- Antonette S Cabello
- Danielle Lauren Cabral
- Christopher Cabullo
- Frank Cacace
- Kristina Oxsavia Cacerez
- Melissa Ann Calandrella
- Ricardo M Calderon
- Marianne Califano
- Guillermo Calleja
All providers in Great Neck, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.