Individual provider Active NPI

Michael L Matthews, PT

  • Physical Therapist
  • Southlake, TX
National Provider Identifier
1376848895
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1200620 Issued in TX
Practice address
1545 E Southlake Blvd
Suite 100
Southlake, TX 76092-6422
Phone
(817) 442-9300
Fax
(817) 796-0763
NPI assigned
Jan 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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 1200620 TX Primary

Addresses

Primary practice location

1545 E Southlake Blvd
Suite 100
Southlake, TX 76092-6422

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110720000035 TX Practitioner - Physical Therapist in Private Practice 2466620331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1200620TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC CurrentSince Mar 14, 2022 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Mar 14, 2022 Accepting new patients
Joseph Daniels, DO CurrentSince Apr 24, 2018 Accepting new patients
Joseph Daniels, DO CurrentSince Apr 24, 2018 Accepting new patients
Sportherapy LLC Physical Therapist PastSince Sep 20, 2019 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

6311 Southwest Blvd
Benbrook, TX 76132
Phone (817) 731-9400

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

7410 McCart Ave
Ste 108
Fort Worth, TX 76133
Phone (682) 350-4318

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20617/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1294876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1376848895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 E SOUTHLAKE BLVD",
            "address_2": "SUITE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926422",
            "telephone_number": "817-442-9300",
            "fax_number": "817-796-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-13",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1200620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.