Matthew Morgan Shine

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10306 Issued in LA

Practice address

4637 S Carrollton Ave
New Orleans, LA 70119-6024

Phone

(504) 525-2225

Fax

(504) 324-8276

NPI assigned

Aug 31, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Louisiana State University School of Medicine in New Orleans, 2019

Medicare assignment

May accept Medicare assignment

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 and National Provider Directory roles.

• Performance Rehabilitation Services, LLC

  • Orthopedic Physical Therapist
  • La Place, LA
  • NPI 1396708186
  Medicare reassignment NPD

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1497531958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700690309",
            "telephone_number": "504-525-2225",
            "fax_number": "504-324-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4637 S CARROLLTON AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701196024",
            "telephone_number": "504-525-2225",
            "fax_number": "504-324-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINE",
        "first_name": "MATTHEW",
        "middle_name": "MORGAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251E1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Ergonomics",
            "state": "LA",
            "license": "10306",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "LA",
            "license": "10306",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "LA",
            "license": "10306",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "10306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Katherine Shields
• Matthew Patrick Shields
• Jonathan Shih
• Komei Shimozono, M.D.
• Shine Through, LLC
• Shining Star Transportation LLC
• Tyler Shipley
• Megan Marie Shipsky, PHARMD
• Shira Glazer
• Namita G Shiralkar, MD

• Physical Therapist in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.