Individual provider Active NPI

Matthew Allan Grayson Midkiff, PT DPT CSCS

  • Physical Therapist
  • Chandler, AZ
National Provider Identifier
1194752907
Registry record updated Dec 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5882 Issued in AZ
Practice address
825 E Warner Rd
Ste C-100
Chandler, AZ 85225-0994
Phone
(480) 722-0300
Fax
(480) 722-0302
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5882 AZ Primary

Addresses

Primary practice location

825 E Warner Rd
Ste C-100
Chandler, AZ 85225-0994

Mailing address

825 E Warner Rd
Ste C-100
Chandler, AZ 85225-0994
Phone (480) 722-0300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040803001450 AZ Practitioner - Physical Therapist in Private Practice 1254302235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15410 S Mountain Pkwy
Suite 112
Phoenix, AZ 85044-6691
Phone (480) 940-8299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5882AZMDIndependent Medical Examiner Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Sports Medicine & Rehabilitation, LLC CurrentSince Jul 6, 2010 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Jul 6, 2010 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist Current Accepting new patients
Stat,LLC Past Accepting new patients
Catz Physical Therapy Past Accepting new patients

Locations

6788 S Kings Ranch Rd
Ste 4
Gold Canyon, AZ 85118
Phone (480) 982-1909

1702 S Val Vista Dr
Ste 107
Mesa, AZ 85204
Phone (480) 505-8140

15410 S Mountain Pkwy
Ste 112
Phoenix, AZ 85044
Phone (480) 609-0822

21811 N Scottsdale Rd
Ste 120
Scottsdale, AZ 85255
Phone (480) 513-6854

3305 N Swan Rd
Ste 115
Tucson, AZ 85712
Phone (520) 321-0204

Organizations & group practices 5

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229040000000",
    "number": "1194752907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E WARNER RD",
            "address_2": "STE C-100",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852250994",
            "telephone_number": "480-722-0300",
            "fax_number": "480-722-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E WARNER RD",
            "address_2": "STE C-100",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852250994",
            "telephone_number": "480-722-0300",
            "fax_number": "480-722-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDKIFF",
        "first_name": "MATTHEW",
        "middle_name": "ALLAN GRAYSON",
        "name_prefix": "Dr.",
        "credential": "PT DPT CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.