Individual provider Active NPI

Matthew Reddick Perry Jr., RPT

  • Physical Therapist
  • Inglewood, CA
National Provider Identifier
1356363360
Registry record updated Oct 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT16833 Issued in CA
Practice address
323 N Prairie Ave Ste 237
Inglewood, CA 90301-4504
Phone
(310) 330-1177
Fax
(310) 330-1188
NPI assigned
Jul 25, 2006
Last updated
Oct 18, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2017

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 PT16833 CA Primary

Addresses

Primary practice location

323 N Prairie Ave Ste 237
Inglewood, CA 90301-4504

Mailing address

323 N Prairie Ave Ste 237
Inglewood, CA 90301-4504
Phone (310) 330-1177

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060120000875 CA Practitioner - Physical Therapist in Private Practice 0042234676 Practice locations: Inglewood, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

323 N Prairie Ave
Inglewood, CA 90301-4504
Phone (310) 330-1177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dynamics Inc PastSince Aug 1, 2006 Accepting new patients
Advanced Dynamic Therapies Professional Corporation Physical Therapist PastSince Oct 28, 2008 Accepting new patients
Orthopedic Center for Excellence Medical Group a Medical Corp Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Home Rehabilitation Healthcare Agency, IncInglewood, CA, CCN 058265 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Director (100%)
Operational/Managerial Control (5%)
Dec 10, 2019
Feb 19, 2013
Feb 19, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508284800000",
    "number": "1356363360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE STE 237",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014504",
            "telephone_number": "310-330-1177",
            "fax_number": "310-330-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE STE 237",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014504",
            "telephone_number": "310-330-1177",
            "fax_number": "310-330-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "MATTHEW",
        "middle_name": "REDDICK",
        "name_suffix": "Jr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2017-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT16833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.