Individual provider Active NPI

Matthew Fugate, PT

  • Physical Therapist
  • Surprise, AZ
National Provider Identifier
1396320669
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-31663 Issued in AZ
Practice address
16811 N Litchfield Rd Ste 101
Surprise, AZ 85374-7062
Phone
(602) 313-4045
Fax
(623) 322-0664
NPI assigned
Mar 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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 GA
Physical Therapist 225100000X LPT-31663 AZ Primary

Addresses

Primary practice location

16811 N Litchfield Rd Ste 101
Surprise, AZ 85374-7062

Mailing address

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

Other practice location 1

920 Marietta Hwy Ste 340
Roswell, GA 30075-6751
Phone (470) 857-3604

Other practice location 2

3850 W Happy Valley Rd Ste 147149
Glendale, AZ 85310-3280
Phone (623) 322-8925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, GA, TN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210407001674 AZ Practitioner - Physical Therapist in Private Practice 6103233226 Reassigns benefits to 2 organizations
I20240321000521 GA Practitioner - Physical Therapist in Private Practice 6103233226 Reassigns benefits to 1 organization
I20260504007580 TN Practitioner - Physical Therapist in Private Practice 6103233226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians
MCM Rehabilitation LLCGroup PAC ID 5294798336, 58 clinicians

Practice addresses (Care Compare)

16811 N Litchfield Rd
Suite 101
Surprise, AZ 85374-7062
Phone (623) 322-0654

222 Sequoyah Rd
Suite 4
Soddy Daisy, TN 37379-5154
Phone (423) 332-3601

920 Marietta Hwy
Suite 340
Roswell, GA 30075-6751
Phone (470) 857-3604

Merit-based Incentive Payment System (MIPS)

Final score
86.7 of 100Reported as group
Quality
90
Improvement activities
40
Cost
73.99

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-31663AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Sports Medicine & Rehabilitation, LLC CurrentSince Sep 19, 2022 Accepting new patients
MCM Rehabilitation, LLC. Physical Therapist CurrentSince Jan 29, 2024 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Sep 19, 2022 Accepting new patients
MCM Rehabilitation LLC CurrentSince Jan 29, 2024 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Mar 29, 2021 Accepting new patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Jul 28, 2025 Accepting new patients
Ideal Rehabilitation LLC PastSince Apr 13, 2025 Accepting new patients

Locations

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

3850 W Happy Valley Rd
Ste 147
Glendale, AZ 85310
Phone (623) 322-8925

3850 W Happy Valley Rd
Ste 147149
Glendale, AZ 85310
Phone (623) 322-8925

6788 S Kings Ranch Rd
Ste 4
Gold Canyon, AZ 85118
Phone (480) 982-1909

9069 W Olive Ave
Ste 105
Peoria, AZ 85345
Phone (623) 257-2079

15410 S Mountain Pkwy
Ste 112
Phoenix, AZ 85044
Phone (480) 609-0822

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

16811 N Litchfield Rd
Ste 101
Surprise, AZ 85374
Phone (602) 313-4045

3305 N Swan Rd
Ste 115
Tucson, AZ 85712
Phone (520) 321-0204

1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288

1343 W Walnut Ave
Dalton, GA 30720
Phone (706) 913-8201

3154 Johnson Ferry Rd
Ste 100
Marietta, GA 30062
Phone (678) 256-0758

97 Gateway Business Park Dr
Ringgold, GA 30736
Phone (706) 937-5771

920 Marietta Hwy
Ste 340
Roswell, GA 30075
Phone (470) 857-3604

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cr
Chicago, IL 60674

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

222 Sequoyah Rd
Ste 4
Soddy Daisy, TN 37379
Phone (423) 332-3601

Organizations & group practices 7

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": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1396320669",
    "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": "16811 N LITCHFIELD RD STE 101",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747062",
            "telephone_number": "602-313-4045",
            "fax_number": "623-322-0664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Marietta Hwy Ste 340",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300756751",
            "country_code": "US",
            "telephone_number": "470-857-3604",
            "fax_number": "470-777-4259",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3850 W Happy Valley Rd Ste 147149",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853103280",
            "country_code": "US",
            "telephone_number": "623-322-8925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUGATE",
        "first_name": "MATTHEW",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-17",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-31663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.