MATTHEW RANDOLPH STOODLEY (DPT) – Physical Therapist, NPI 1124912118

MATTHEW RANDOLPH STOODLEY (DPT) is a healthcare provider. based in Wilkes barre, Pennsylvania. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT033285 (PA). The NPI Number for MATTHEW RANDOLPH STOODLEY (DPT) is 1124912118

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
MATTHEW RANDOLPH STOODLEY (DPT)
NPI
1124912118
Phone
(570) 970-0402
Address
182 BUTLER ST
Enumeration Date
5 June 2025
Last Update Date
5 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5709700402
Graduation Year
2025 (1 year ago)
PAC ID
3476065434
Group Practice PAC ID
0840664918
Professional Enrollment ID
I20250625001045
Address ID
PA187024465WI182XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

4,258 PHYSICAL THERAPIST IN PRIVATE PRACTICE in PA

Provider Addresses for MATTHEW RANDOLPH STOODLEY (DPT)

  • 182 BUTLER ST

    WILKES BARRE, PA 187024465

    Phone: (570) 970-0402

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-06-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250625001045IPhysical Therapist In Private PracticePATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 18702)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840664918View full group profile
NameSpecialtyState
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA

Reviews

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Frequently asked questions

What is the 10-digit NPI for MATTHEW RANDOLPH STOODLEY (DPT)?
MATTHEW RANDOLPH STOODLEY (DPT) — NPI 1124912118 — is the standard way to identify this listing.
Does the file indicate MATTHEW RANDOLPH STOODLEY (DPT) is practicing under active NPI?
Directory data currently reports MATTHEW RANDOLPH STOODLEY (DPT) as active.
What is MATTHEW RANDOLPH STOODLEY (DPT)'s specialty?
The listing groups MATTHEW RANDOLPH STOODLEY (DPT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is MATTHEW RANDOLPH STOODLEY (DPT) based?
MATTHEW RANDOLPH STOODLEY (DPT) is tied to Wilkes Barre, Pennsylvania in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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