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MATTHEW PUDERBAUGH D.O. NPI 1982959771


NPI Information

NPI: 1982959771
Provider Name: MATTHEW PUDERBAUGH, D.O.
Classification: Physical Medicine & Rehabilitation - 2081P0301X
Entity Type: Individual

Specialization: Brain Injury Medicine

PECOS Registration: Yes

Address:
715 S 8TH ST
MINNEAPOLIS, MN
ZIP 55404
Phone: (612) 873-3000
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Matthew Puderbaugh, D.O. is a brain injury medicine physical medicine rehabilitation in Minneapolis, MN with 12 years of experience. The provider is a Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical, physical, neurologic, cognitive, sensory, and behavioral disorders that result in psychosocial, educational, and vocational consequences. Matthew Puderbaugh, D.O. NPI is 1982959771. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: ROCKY VISTA UNIVERSITY COLLEGE OF OSTEOPATHIC MED
Graduation Year:2012

The provider's business location address is:

715 S 8TH ST
MINNEAPOLIS, MN
ZIP 55404-210
Phone: (612) 873-3000

The NPI 1982959771 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/17/2012 and was last updated on 6/10/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral Practice5101019889MICHIGANNo
2390200000XStudent in an Organized Health Care Education/Training ProgramNo
32081P0301XPhysical Medicine & RehabilitationBrain Injury Medicine70248MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.