Matthew Wiseman, in Provo, UT - Medicare Physical Therapist Provider

Matthew Wiseman, is a medicare enrolled "Physical Therapist" provider in Provo, Utah. His current practice location is 445 N University Ave, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (208) 757-0805.

Matthew Wiseman is licensed to practice in Utah (license number 10358145-2401) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1184929168.

Contact Information

	Matthew Wiseman,
	445 N University Ave, Provo, UT 84601-2863
	(208) 757-0805
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Matthew Wiseman
Gender	Male
Speciality	Physical Therapist
Location	445 N University Ave, Provo, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1184929168
Provider Enumeration Date: 01/21/2011
Last Update Date: 09/04/2020

Medicare PECOS Information:

PECOS PAC ID: 2264952373
Enrollment ID: I20250219003230

Medical Identifiers

Medical identifiers for Matthew Wiseman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184929168	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PT-3831 (Idaho)	Secondary
225100000X	Physical Therapist	10358145-2401 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Matthew Wiseman allows following entities to bill medicare on his behalf.

Provider Name	Dmxq, Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1265946073 PECOS PAC ID: 0446580203 Enrollment ID: O20190923001151

Provider Name	Blue Lagune Therapy, Inc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1699152074 PECOS PAC ID: 1759773302 Enrollment ID: O20220112000384

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Matthew Wiseman is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Matthew Wiseman, 445 N University Ave, Provo, UT 84601-2863 Ph: (208) 757-0805	Matthew Wiseman, 445 N University Ave, Provo, UT 84601-2863 Ph: (208) 757-0805

Reviews and Comments

Physical Therapist in Provo, UT

Rhonda L Metcalf, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-373-7850
Brandon Niel Smith, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 68 N 2830 W, Provo, UT 84601 Phone: 801-310-2207
Ms. Maryjane Ligairi, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-373-7850
Jacie Saltzman, Physical Therapist Medicare: Medicare Enrolled Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-7850
Monica Maria Alvarez Hinckley, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1157 N 300 W, Provo, UT 84604 Phone: 801-357-1250 Fax: 801-357-1255
Mcclean Chiropractic Clinic, Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 385 N 500 W, Provo, UT 84601 Phone: 801-373-1035 Fax: 801-373-1038
Brent R Butler, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1055 N 500 W Ste 122, Provo, UT 84604 Phone: 801-429-0610 Fax: 801-429-0629

Matthew Wiseman, - Medicare Physical Therapist in Provo, UT