Individual provider Active NPI

Matthew Ray Dewall, MPT CSCS

  • Physical Therapist
  • Indianola, IA
National Provider Identifier
1194782961
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03373 Issued in IA
Practice address
1507 North 1St St
Indianola, IA 50125
Phone
(515) 382-3366
Fax
(515) 382-1576
NPI assigned
Apr 27, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 03373 IA Primary

Addresses

Primary practice location

1507 North 1St St
Indianola, IA 50125

Mailing address

PO Box 461
Nevada, IA 50201-0461
Phone (515) 382-3366

Other identifiers 3

IdentifierTypeStateIssuer
46364OtherIABCBS AH
36592OtherIABCBS IND
46363OtherIABCBS GR & MADRID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250414001551 IA Practitioner - Physical Therapist in Private Practice 4082691811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
21St Century Rehab PCGroup PAC ID 1456250448, 29 clinicians

Practice addresses (Care Compare)

1507 N 1St St
Indianola Physical Therapy
Indianola, IA 50125-3703
Phone (515) 961-7435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
21St Century Rehab, PC Physical Therapist Current Accepting new patients
21St Century Rehab PC CurrentSince Feb 5, 2025 Accepting new patients
21St Century Rehab PC CurrentSince Feb 5, 2025 Accepting new patients

Locations

1003 8th St SW
Ste D
Altoona, IA 50009
Phone (515) 967-4121

125 N 1st St
Carlisle, IA 50047
Phone (515) 989-0100

1507 N 1st St
Indianola, IA 50125
Phone (515) 961-7435

209 W 2nd St
Madrid, IA 50156
Phone (515) 795-2427

109 W McLane St
Osceola, IA 50213
Phone (641) 342-1470

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1194782961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 461",
            "city": "NEVADA",
            "state": "IA",
            "postal_code": "502010461",
            "telephone_number": "515-382-3366",
            "fax_number": "515-382-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 NORTH 1ST ST",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "50125",
            "telephone_number": "515-382-3366",
            "fax_number": "515-382-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWALL",
        "first_name": "MATTHEW",
        "middle_name": "RAY",
        "credential": "MPT CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AH",
            "identifier": "46364",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IND",
            "identifier": "36592",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GR & MADRID",
            "identifier": "46363",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianola, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.