Active NPI
Matthew J Moore, P.T.
- Physical Therapist
- Moline, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-012189
- Practice address
- 520 Valley View Dr Ste 200
Moline, IL 61265-6152 - Phone
- (309) 797-0866
- Fax
- (309) 797-0872
- NPI assigned
- May 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070-012189 | IL | Primary |
Addresses
Primary practice location
520 Valley View Dr Ste 200
Moline, IL 61265-6152
Mailing address
850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070-012189 | Other | IL | ILLINOIS PT LICENSE NO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
850 43Rd Ave
Suite 300
Moline, IL 61265-8401
Phone (309) 743-0300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-012189 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ora Orthopedics, PC | Current | Accepting new patients | |
| Rock Valley Physical Therapy Center | Physical Therapist | Current | Accepting new patients |
| Ora Orthopedics PC | Current | Accepting new patients | |
| Rock Valley Physical Therapy Center | Physical Therapist | Current | Accepting new patients |
Locations
2300 53rd Ave
Ste LL04
Bettendorf, IA 52722
850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070
850 43rd Ave
Ste 300
Moline, IL 61265
Phone (309) 743-0300
520 Valley View Dr
Ste 200
Moline, IL 61265
Phone (309) 797-0866
520 Valley View Dr
Moline, IL 61265
Phone (309) 762-1952
Organizations & group practices 4
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.
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Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334188800000",
"number": "1376590836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 43RD AVE STE 100",
"city": "MOLINE",
"state": "IL",
"postal_code": "612658401",
"telephone_number": "309-743-2070",
"fax_number": "309-743-2073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 VALLEY VIEW DR STE 200",
"city": "MOLINE",
"state": "IL",
"postal_code": "612656152",
"telephone_number": "309-797-0866",
"fax_number": "309-797-0872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "MATTHEW",
"middle_name": "J",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-30",
"last_updated": "2012-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-012189",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS PT LICENSE NO",
"identifier": "070-012189",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.