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

Matthew Wagner, PT

Individual provider Physical Therapist · NPI 1043413859

Matthew Wagner, PT is a Physical Therapist in Private Practice in Boulder, Colorado. Qualified in 2006, 20 years ago. Practices with Boulder Community Health, a 253-clinician group and accepts Medicare assignment. Licensed in Colorado and New York.

Years since qualifying
20
Licensed in
CO, NY
In the registry since
2007
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

2150 Stadium Dr
Boulder, CO 80309-1361
Phone: (303) 315-9900
Fax: (303) 315-9902
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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 PTL.0010633 (CO)
Physical Therapist Taxonomy 225100000X · Licence 029375 (NY)

Record details

NPI number1043413859
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedJune 8, 2007
Last updated in NPPESSeptember 29, 2022
Certification dateSeptember 29, 2022
Mailing address1514 Cedarwood Dr, Longmont, CO 80504-8785

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Boulder Community Health — 253 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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