Active NPI
Matthew Debole, PT, DPT
- Physical Therapist
- Palo Alto, CA
National Provider Identifier
1588060271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3600
- Practice address
- 795 El Camino Real
Clark Building, Level 1
Palo Alto, CA 94301-2302 - Phone
- (650) 853-3355
- NPI assigned
- Nov 7, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3600 | ID | Primary |
Addresses
Primary practice location
795 El Camino Real
Clark Building, Level 1
Palo Alto, CA 94301-2302
Mailing address
795 El Camino Real
Clark Building, Level 1
Palo Alto, CA 94301-2302
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3600 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415318400000",
"number": "1588060271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "795 EL CAMINO REAL",
"address_2": "CLARK BUILDING, LEVEL 1",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943012302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "795 EL CAMINO REAL",
"address_2": "CLARK BUILDING, LEVEL 1",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943012302",
"telephone_number": "650-853-3355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBOLE",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-07",
"last_updated": "2014-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "3600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.