Matthew Charles Kirsten, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

42121 Issued in CA

Practice address

26302 La Paz Rd
Suite 105
Mission Viejo, CA 92691-5313

Phone

(949) 206-1700

Fax

(949) 206-1800

NPI assigned

Jan 22, 2015

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 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Impact Phytherapy and Performance Fna Ko Golf Performance and PT PCGroup PAC ID 2264855824, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Impact Phytherapy and Performance Fna Ko Golf Performance & PT PC

  • Orthopedic Physical Therapist
  • Laguna Niguel, CA
  • NPI 1346706025

  CA

  Medicare reassignment Care Compare group
• Lakeside Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Mission Viejo, CA
  • NPI 1093945891

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1255720686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWPORT CENTER DR",
            "address_2": "#213",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607501",
            "telephone_number": "949-644-1322",
            "fax_number": "949-644-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26302 LA PAZ RD",
            "address_2": "SUITE 105",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915313",
            "telephone_number": "949-206-1700",
            "fax_number": "949-206-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSTEN",
        "first_name": "MATTHEW",
        "middle_name": "CHARLES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "PENDING",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georg Kiriak, D.D.S.
• Alex Jesse Kirkpatrick, PT, DPT
• Peggy Kirkwood, RN,NP
• Deborah Lynn Kirschbaum, PH.D.
• Stuart Kirschbaum, PH.D.
• Lauren L Kiscaden, PA
• Heidi Kitsu
• Mouriann Kleeh Kleeh
• Timothy Lee Klein-Mohr, PTA
• Lisa Marie Klimpel, CPNP

• All providers in Mission Viejo, CA
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.