Matt C Paul, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

12722 Tonkel Rd Ste 102
Fort Wayne, IN 46845-8201

Phone

(260) 739-0300

NPI assigned

Aug 4, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Protailored Physical Therapy LLCGroup PAC ID 4385962497, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Protailored Physical Therapy LLC

  • Orthopedic Physical Therapist
  • Fort Wayne, IN
  • NPI 1063805042
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1245840370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12722 TONKEL RD STE 102",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468458201",
            "telephone_number": "260-905-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12722 TONKEL RD STE 102",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468458201",
            "telephone_number": "260-739-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "MATT",
        "middle_name": "C",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-04",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "05013789A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300041301",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Cordell Patton, LAT,ATC
• Leah Patton, MD
• Molly Patton, RBT
• Kabita Paudel
• Erica Paul
• Paula Ruth Paul, MS, OTR
• Stefanie Ann Paulson, MD
• Sherriya Paw
• Karen Pawlak, PHARMD
• Thomas Brian Pawlik, ATC

• Physical Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.