Individual provider Active NPI

Matthew Elizondo

  • Physical Therapist
  • Katy, TX
National Provider Identifier
1245475870
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1185716 Issued in TX
Practice address
23225 Kingsland Blvd Ste 600
Suite 600
Katy, TX 77494-3705
Phone
(281) 395-9090
NPI assigned
Dec 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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 1185716 TX Primary

Addresses

Primary practice location

23225 Kingsland Blvd Ste 600
Suite 600
Katy, TX 77494-3705

Mailing address

23225 Kingsland Blvd Ste 600
Suite 600
Katy, TX 77494-3705
Phone (281) 395-9090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090724000146 TX Practitioner - Physical Therapist in Private Practice 5496808388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spero Rehabilitation, LLCGroup PAC ID 5890988216, 53 clinicians

Practice addresses (Care Compare)

5401 La Crosse Ave
BLDG C
Austin, TX 78739-2160
Phone (512) 852-8134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1185716TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spero Rehabilitation LLC Physical Therapist CurrentSince Aug 7, 2016 Accepting new patients
Children'S Hospital Pediatric Associates, Inc PastSince Aug 7, 2016 Accepting new patients
Lynn Jackson, PT, PC Physical Therapist Past Accepting new patients

Locations

5401 La Crosse Ave
Ste 101
Austin, TX 78739
Phone (512) 852-8134

4225 Guadalupe St
Austin, TX 78751
Phone (737) 204-0089

5401 La Crosse Ave
Bldg C
Austin, TX 78739
Phone (512) 852-8134

6012 W William Cannon Dr
Ste C101
Austin, TX 78749
Phone (512) 899-8508

23225 Kingsland Blvd
Ste 600
Katy, TX 77494
Phone (281) 395-9090

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": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1245475870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23225 KINGSLAND BLVD STE 600",
            "address_2": "SUITE 600",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774943705",
            "telephone_number": "281-395-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23225 KINGSLAND BLVD STE 600",
            "address_2": "SUITE 600",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774943705",
            "telephone_number": "281-395-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZONDO",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1185716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.