Matthew Kooy, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT009707 Issued in GA

Practice address

1669 Phoenix Pkwy
Ste. 102
College Park, GA 30349-5464

Phone

(770) 907-1023

Fax

(770) 907-5608

NPI assigned

Aug 4, 2009

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 WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emerald City Physical Therapy SVCS LLCGroup PAC ID 0547442469, 20 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 and National Provider Directory roles.

• Emerald City Physical Therapy SVCS, LLC

  • Physical Medicine & Rehabilitation Physician
  • Seattle, WA
  • NPI 1881998482
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249344000000",
    "number": "1154552529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 PHOENIX PKWY",
            "address_2": "STE. 102",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495464",
            "telephone_number": "770-907-1023",
            "fax_number": "770-907-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 PHOENIX PKWY",
            "address_2": "STE. 102",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495464",
            "telephone_number": "770-907-1023",
            "fax_number": "770-907-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOY",
        "first_name": "MATTHEW",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-04",
        "last_updated": "2009-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lashonda Lane
• Donald F Langenbeck Jr., M.D.
• Shawn Leach-Manley
• Leah Johnson McFerren, O.D., P.C.

• Physical Therapist in College Park, GA
• Providers in College Park, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; 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.