MATTHEW ANGE (OTR) – Occupational Therapist, NPI 1104206267

MATTHEW ANGE (OTR) is a healthcare provider. based in Fort worth, Texas. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR. They hold a License No. 115325 (TX). The NPI Number for MATTHEW ANGE (OTR) is 1104206267

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
MATTHEW ANGE (OTR)
NPI
1104206267
Phone
Not provided
Address
1101 W ROSEDALE ST
Enumeration Date
4 June 2015
Last Update Date
10 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8178857951
Graduation Year
2012 (14 years ago)
PAC ID
8628309424
Group Practice PAC ID
8224287545
Professional Enrollment ID
I20191009001058
Address ID
TX761042824FO1300XSTXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

825 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for MATTHEW ANGE (OTR)

  • 1101 W ROSEDALE ST

    FORT WORTH, TX 761044425

    Phone:

    Type: Mailing

  • 1300 W ROSEDALE ST STE B

    FORT WORTH, TX 761042824

    Phone: (817) 885-7951

    Fax: (178) 857-9538

    Type: Location

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: 2019-10-09

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
I20191009001058IOccupational Therapist In Private PracticeTXTBD

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 76104)

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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: 8224287545View full group profile
NameSpecialtyState
O P T O M E T R YTX

Reviews

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Frequently asked questions

What is the standard ID for MATTHEW ANGE (OTR) in the U.S.?
In the U.S., MATTHEW ANGE (OTR) is identified by NPI 1104206267.
Quick check: is MATTHEW ANGE (OTR) active?
Public NPPES data shows MATTHEW ANGE (OTR) with an active NPI status right now.
What does the directory say MATTHEW ANGE (OTR) does?
Insurance directories may phrase it differently, but here MATTHEW ANGE (OTR) maps to Occupational Therapist. Clinical services aligned with this taxonomy classification.
Can patients visit MATTHEW ANGE (OTR) in Fort Worth, Texas?
For routing, start with Fort Worth, Texas for MATTHEW ANGE (OTR), then verify phone and hours locally.
Why is information missing for MATTHEW ANGE (OTR)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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