Individual provider Active NPI

Matthew Brian Leach, MS,PT

  • Physical Therapist
  • Louisville, KY
National Provider Identifier
1366473985
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003741 Issued in KY
Practice address
9368 Cedar Center Way
Louisville, KY 40291-4522
Phone
(502) 231-3979
Fax
(502) 231-9891
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05007438A IN
Physical Therapist 225100000X 003741 KY Primary

Addresses

Primary practice location

9368 Cedar Center Way
Louisville, KY 40291-4522

Mailing address

11503 Hopi CT
Louisville, KY 40299-5847
Phone (502) 267-1491

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110714000334 KY Practitioner - Physical Therapist in Private Practice 4284802422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SN Kentuckiana Rehab, LLCGroup PAC ID 1254671464, 339 clinicians

Practice addresses (Care Compare)

9368 Cedar Ctr Way
Louisville, KY 40291-4522
Phone (502) 231-3979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
05007438AINMDPhysical Therapist
003741KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
SN Kentuckiana Rehab, LLC Physical Therapist Current Accepting new patients
SN Kentuckiana Rehab, LLC CurrentSince Apr 1, 2019 Accepting new patients
SN Kentuckiana Rehab, LLC CurrentSince Apr 1, 2019 Accepting new patients

Locations

9368 Cedar Center Way
Louisville, KY 40291
Phone (502) 231-3979

210 E Gray St
Ste 807
Louisville, KY 40202
Phone (502) 587-9350

12613 Taylorsville Rd
Ste 118
Louisville, KY 40299
Phone (502) 267-1480

7926 Preston Hwy
Ste 101
Louisville, KY 40219
Phone (502) 298-5658

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1366473985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11503 HOPI CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402995847",
            "telephone_number": "502-267-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9368 CEDAR CENTER WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402914522",
            "telephone_number": "502-231-3979",
            "fax_number": "502-231-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "MATTHEW",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "MS,PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05007438A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "003741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.