Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Matthew Detore, MPT

Individual provider Physical Therapist · NPI 1538498217

Matthew Detore, MPT is a Physical Therapist in Private Practice in Philadelphia, Pennsylvania. Qualified in 2009, 17 years ago. Practices as a sole proprietor. Licensed in New Jersey and Pennsylvania.

Years since qualifying
17
Licensed in
NJ, PA
In the registry since
2009
Specialties on file
2
What do these letters mean?
MPT — Master of Physical Therapy
The master's-level physical therapy degree awarded before the DPT became standard.

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Practice location Address checks out

6595 Roosevelt Blvd B
Philadelphia, PA 19149-2918
Phone: (215) 743-2332
Fax: (215) 743-2330
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 40QA0Q1559200 (NJ)
Physical Therapist Taxonomy 225100000X · Licence PT022243 (PA)

Record details

NPI number1538498217
Entity typeIndividual (Type 1)
GenderMale
Credentials MPT
Sole proprietorYes
NPI enumeratedDecember 9, 2009
Last updated in NPPESApril 14, 2026
Certification dateApril 14, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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