Individual provider Active NPI

Matthew Nieh

  • Orthopedic Physical Therapist
  • West Covina, CA
National Provider Identifier
1417787276
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
306482 Issued in CA
Practice address
501 S Vincent Ave Ste 200
West Covina, CA 91790-6712
Phone
(626) 856-5588
NPI assigned
Aug 6, 2024
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 306482 CA Primary

Addresses

Primary practice location

501 S Vincent Ave Ste 200
West Covina, CA 91790-6712

Mailing address

1626 Green Ridge Ter
West Covina, CA 91791-4318
Phone (626) 383-4939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241002000820 CA Practitioner - Physical Therapist in Private Practice 7618408659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sand Coast Rehab Physical Therapy IncGroup PAC ID 7315352911, 131 clinicians

Practice addresses (Care Compare)

824 W Cameron Ave
West Covina, CA 91790-4136
Phone (732) 994-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
306482CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
360 Wellness Physical Therapy Single Specialty CurrentSince Aug 11, 2024 Accepting new patients
Sand Coast Rehab Physical Therapy Inc Single Specialty CurrentSince Aug 5, 2024 Accepting new patients

Locations

441 E Carson St
Ste K
Carson, CA 90745
Phone (732) 375-0420

3558 Round Barn Blvd
Ste 600
Santa Rosa, CA 95403

501 S Vincent Ave
Ste 200
West Covina, CA 91790
Phone (626) 727-6688

400 Route 70
Lakewood, NJ 08701
Phone (440) 263-9228

Organizations & group practices 2

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": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1417787276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 GREEN RIDGE TER",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917914318",
            "telephone_number": "626-383-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S VINCENT AVE STE 200",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917906712",
            "telephone_number": "626-856-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEH",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "306482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.