Matthew Madere, MPT
Individual provider Active NPI Physical Therapist · Brusly, LA
NPI 1194753129 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1194753129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 06567 (LA)
- Practice address
- 400 W Saint Francis St
Suite C1
Brusly, LA 70719-2283 - Phone
- (225) 749-8980
- Fax
- (225) 749-9096
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
27999 Old STH Walker Rd
Suite B
Walker, LA 70785-6048
27999 Old STH Walker Rd B
Ace PT
Walker, LA 70785-6048
Phone (225) 455-2233
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041101001176 | LA | Practitioner - Physical Therapist in Private Practice | 1850353897 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ace Physical Therapy, LLC | Current |
Accepting new patients | |
| Peak Performance Physical Therapy and Fitness, LLC | Physical Therapist | Past |
Accepting new patients |
| McMorris Chiropractic, LLC | Past |
Accepting new patients |
Locations
27999 Old Sth Walker Rd
Ste B
Walker, LA 70785
Phone (225) 271-4083
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 06567 | LA | Yes |
Addresses
Primary practice location
400 W Saint Francis St
Suite C1
Brusly, LA 70719-2283
Mailing address
11320 Industriplex Boulevard
Baton Rouge, LA 70809
Phone (225) 295-8183
Other providers in Brusly, LA
- Innis Community Health Center, Inc
- Innis Community Health Center, Inc
- Natasha Williams Jones
- Alaina Renee Landry
- Louisiana Cni, LLC
- Clifton A Miller Jr.
- Fayun Raynia Morris
- Kimberly Murphy
- Noahs Pharmacy,LLC
- Normal Life of Lafayette, Inc.
All providers in Brusly, LA · Physical Therapist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.