Individual provider Active NPI

Bryce Matthews, D.C.

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1164732012
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC31800 Issued in CA
Practice address
3030 Sawtelle Blvd
Los Angeles, CA 90066-1408
Phone
(310) 391-2617
Fax
(310) 390-0868
NPI assigned
Oct 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC31800 CA Primary

Addresses

Primary practice location

3030 Sawtelle Blvd
Los Angeles, CA 90066-1408

Mailing address

3030 Sawtelle Blvd
Los Angeles, CA 90066-1408
Phone (310) 391-2617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111004000179 CA Practitioner - Chiropractic 7315119922 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sherman Oaks Integrated Medical Group, Inc.Group PAC ID 8729368659, 5 clinicians

Practice addresses (Care Compare)

4835 Van Nuys Blvd
Suite 105
Sherman Oaks, CA 91403-2132
Phone (818) 786-5985

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC31800CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Sherman Oaks Integrated Medical Group, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Health Atlast West la CurrentSince Mar 16, 2014 Accepting new patients
Health Atlast West la Inc CurrentSince Mar 16, 2014 Accepting new patients

Locations

3030 Sawtelle Blvd
Los Angeles, CA 90066
Phone (310) 390-9018

4835 Van Nuys Blvd
Ste 105
Sherman Oaks, CA 91403
Phone (818) 786-5985

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1164732012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 SAWTELLE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900661408",
            "telephone_number": "310-391-2617",
            "fax_number": "310-390-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 SAWTELLE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900661408",
            "telephone_number": "310-391-2617",
            "fax_number": "310-390-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "BRYCE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-13",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC31800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.