Matthew Taylor Vander Kooi, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-30902 Issued in AZ

Practice address

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

Phone

(623) 322-0654

Fax

(623) 322-0664

NPI assigned

Sep 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM, WA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tuohy Physical Therapy LLCGroup PAC ID 2264577550, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Tuohy Physical Therapy LLC

  dba Advantage Physical therapy and sports rehabilitation

  • Physical Therapy Clinic/Center
  • Redmond, WA
  • NPI 1336471143
  Medicare reassignment Care Compare group
• Active Solutions Therapy Serv Inc

  • Orthopedic Physical Therapist
  • Edgewood, NM
  • NPI 1720075880
  Medicare reassignment NPD
• Paradigm Physical Therapy and Wellness Inc

  • Physical Therapist
  • Los Lunas, NM
  • NPI 1386651412
  Medicare reassignment NPD
• Ideal Rehabilitation LLC

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1831353614
  NPD (past)
• Active Solutions Therapy Services, Inc

  dba Advanced Healing Physical Therapy

  • Physical Therapist
  • Fort Lupton, CO
  • NPI 1497190557
  NPD (past)
• Paradigm Physical Therapy and Wellness

  • Physical Therapist
  • Albuquerque, NM
  • NPI 1679090633
  NPD (past)

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1477104529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222",
            "fax_number": "630-759-9510"
        },
        {
            "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": "623-322-0654",
            "fax_number": "623-322-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER KOOI",
        "first_name": "MATTHEW",
        "middle_name": "TAYLOR",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-20",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-30902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valleywide Home Care LLC (Valleywide Home Care)
• Christina Joy Van Arsdale
• Van Metre Chiropractic PLLC
• Kirk Williams Van Metre, D.C.
• Larissa Van Wie, RBT
• Jessica Vanderbilt, DNM
• Whitney Vandermer, RD
• Anna Helene Vanderwall
• Der Vang, OD
• Kyri Vanvoorst, MOT, OTR/L

• Physical Therapist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.