Matthew Macdonald

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

50053 Issued in CA

Practice address

215 N State College Blvd Ste G
Anaheim, CA 92806-2932

Phone

(714) 999-6596

Fax

(714) 999-5009

NPI assigned

Sep 12, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• State College Physical Therapy

  • Physical Therapist
  • Anaheim, CA
  • NPI 1699780353
  NPD (past)
• State College Physical Therapy Inc

  • Physical Therapist
  • Anaheim, CA
  • NPI 1689782310
  NPD (past)

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1346890266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12525 SPRINGSNOW CIR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907038326",
            "telephone_number": "408-813-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N STATE COLLEGE BLVD STE G",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062932",
            "telephone_number": "714-999-6596",
            "fax_number": "714-999-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "50053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian T. Ma, M.S.
• Paynepualena Kahakulani Leimomi Ma'Ae
• Jennifer Maas
• Maria Maatouk, COTA
• Shelby Mabery
• Melisse Elaine Mace
• Binh Mach, NP
• Janet G Mach, OD
• Christian Machado
• Richelle Marie Machado

• Physical Therapy Assistant in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.