Individual provider Active NPI

Matt A Sheehan, PT

  • Physical Therapist
  • Stockton, CA
National Provider Identifier
1326091596
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27125 Issued in CA
Practice address
10100 Trinity Pkwy # 435
Stockton, CA 95219-7238
Phone
(209) 474-7881
NPI assigned
May 18, 2006
Last updated
Sep 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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 27125 CA Primary

Addresses

Primary practice location

10100 Trinity Pkwy # 435
Stockton, CA 95219-7238

Mailing address

1952 Della Verona Dr
Roseville, CA 95747-3504
Phone (916) 915-7125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27125CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Natomas Physical Therapy Physical Therapist CurrentSince Nov 8, 2006 Accepting new patients
Sierra Physical Therapy Inc Physical Therapist PastSince Oct 31, 2021 Accepting new patients
Sierra Management Services Inc. Physical Therapist PastSince Mar 1, 2012 Accepting new patients

Locations

1948 Del Paso Rd
Ste 135
Sacramento, CA 95834
Phone (916) 419-5202

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1326091596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1952 DELLA VERONA DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957473504",
            "telephone_number": "916-915-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 TRINITY PKWY # 435",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197238",
            "telephone_number": "209-474-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEHAN",
        "first_name": "MATT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "27125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.