Matthew John Ricci, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-6317 Issued in ID

Practice address

299 Anderson Rd
Shelley, ID 83274-4927

Phone

(208) 782-4744

Fax

(208) 906-1554

NPI assigned

May 23, 2019

Last updated

Dec 2, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Physical Therapy PLLCGroup PAC ID 1052848512, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phoenix Physical Therapy PLLC

  • Physical Therapist
  • Iona, ID
  • NPI 1992521215
  Medicare reassignment Care Compare group NPD Authorized official
• Wright Physical Therapy Limited Partnership

  • Physical Therapist
  • Twin Falls, ID
  • NPI 1730732025
  Medicare reassignment NPD
• Wright Physical Therapy Limited Partnership

  • Physical Therapist
  • Logan, UT
  • NPI 1770317455
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1023675287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E STE 401",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013455",
            "telephone_number": "208-969-9945",
            "fax_number": "208-944-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 ANDERSON RD",
            "city": "SHELLEY",
            "state": "ID",
            "postal_code": "832744927",
            "telephone_number": "208-782-4744",
            "fax_number": "208-906-1554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3125 Valencia Dr",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834047575",
            "country_code": "US",
            "telephone_number": "208-529-3332",
            "fax_number": "208-529-3336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICCI",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-23",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-6317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• One Child Inc
• Brian Osterman, PHARM-D
• Parkway Eyecare PC (Shelley Eyecare)
• Douglas Jed Peterson, D.C.
• Dennis Radford, O.D.
• Meagan Denise Richards, PT, DPT
• Shawn Satterthwaite
• Daniel Schauwecker, PHARMD
• Randall Searle, DC
• Dayne F Shaw, PT, DPT

• Physical Therapist in Shelley, ID
• Providers in Shelley, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.