Active NPI
Matthew Erick Leivas
- Physical Therapy Assistant
- Menifee, CA
National Provider Identifier
1134701303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- Practice address
- 29916 Patriot Dr
Menifee, CA 92584-0351 - Phone
- (509) 415-5648
- NPI assigned
- Apr 26, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | Primary |
Addresses
Primary practice location
29916 Patriot Dr
Menifee, CA 92584-0351
Mailing address
29916 Patriot Dr
Menifee, CA 92584-0351
Phone (509) 415-5648
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Menifee |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619395200000",
"number": "1134701303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29916 PATRIOT DR",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925840351",
"telephone_number": "509-415-5648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29916 PATRIOT DR",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925840351",
"telephone_number": "509-415-5648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIVAS",
"first_name": "MATTHEW",
"middle_name": "ERICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-04-26",
"last_updated": "2021-04-26",
"certification_date": "2021-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Menifee",
"affiliation": "N",
"address_1": "29916 Patriot Dr",
"city": "Menifee",
"state": "CA",
"country_code": "US",
"postal_code": "925840351",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Menifee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.