Matthew Aaron Leary, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT27390 Issued in FL

Practice address

1110 Hospital Rd
Building B
Fort Walton Beach, FL 32547-6778

Phone

(866) 464-3878

Fax

(334) 396-4905

NPI assigned

Sep 21, 2012

Last updated

Sep 21, 2012By 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 FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Axis Physiotherapy Institute, LLCGroup PAC ID 2860825353, 11 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.

• Axis Physiotherapy Institute, LLC

  • Physical Therapist
  • Fort Walton Beach, FL
  • NPI 1790328045
  Medicare reassignment Care Compare group NPD Authorized official
• Axis Physiotherapy Institute

  • Physical Therapist
  • Fort Walton Beach, FL
  • NPI 1265075717
  NPD
• Premier Rehab Management, LLC

  • Physical Therapist
  • Navarre, FL
  • NPI 1821014390
  NPD (past)

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1144571852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242186",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361242186",
            "telephone_number": "334-625-5795",
            "fax_number": "334-396-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 HOSPITAL RD",
            "address_2": "BUILDING B",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476778",
            "telephone_number": "866-464-3878",
            "fax_number": "334-396-4905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEARY",
        "first_name": "MATTHEW",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-21",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT27390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laya Sleep Clinic, LLC
• Elizabeth Le, DMD
• Mary Kay Leach, ARNP
• Rhonda Lynn Leake
• Learning to Heal Therapy, LLC
• Laura Lynne Lebrasseur, ITDS
• Alexandria Ledford
• Lee D. Ettinger, M.D., P.a.
• Whitney T Lee, ATC
• Mary Susan Leger

• Physical Therapist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; 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.