Matthew R Candau, PT, DPT, MTC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-4887 Issued in ID

Practice address

450 W State St Ste 270
Eagle, ID 83616-6974

Phone

(925) 856-7007

NPI assigned

Mar 31, 2015

Last updated

Feb 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MRC LLCGroup PAC ID 0648528570, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• MRC LLC

  dba Performance Physical Therapy of Idaho

  • Physical Therapist
  • Eagle, ID
  • NPI 1295234367
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1457746067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 S BONITO WAY STE 190",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425618",
            "telephone_number": "208-287-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W STATE ST STE 270",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166974",
            "telephone_number": "925-856-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANDAU",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "credential": "PT, DPT, MTC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42444",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-4887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Michael Cahill-Therrien, LMT
• Spencer Reid Calhoun, PT, DPT
• Jennifer Brooke Camareno, MFT
• Isabelle Campbell
• Steven Sean Campregher
• Jessica Brianne Capell, OTR/L
• Care Medical Housecalls PC
• Careconnectmd Idaho PC
• Caring Edge Op LLC
• Abigail Carnline

• Physical Therapist in Eagle, ID
• Providers in Eagle, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.