Individual provider Active NPI

Matthew Kurt Ortiz, MPT, CSCS

  • Physical Therapist
  • Rancho Santa Margarita, CA
National Provider Identifier
1629169701
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT24650 Issued in CA
Practice address
29803 Santa Margarita Pkwy
Rancho Santa Margarita, CA 92688-3609
Phone
(949) 459-9010
Fax
(949) 459-9020
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT24650 CA Primary

Addresses

Primary practice location

29803 Santa Margarita Pkwy
Rancho Santa Margarita, CA 92688-3609

Mailing address

1910 Old Tustin Ave
Santa Ana, CA 92705-7811
Phone (714) 835-6638

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000792 CA Practitioner - Physical Therapist in Private Practice 2668649427 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians
Davis and Watson Physical Therapy Inc.Group PAC ID 7810881554, 4 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

1910 Old Tustin Ave
Santa Ana, CA 92705-7811
Phone (714) 835-6638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT24650CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Apr 26, 2023 Accepting new patients
Davis and Watson Physical Therapy Inc. Physical Therapist CurrentSince Sep 9, 2015 Accepting new patients
Rancho Santa Margarita Physical Therapy Sports Medicine Inc PastSince Jul 15, 1999 Accepting new patients
Scor Physical Therapy Inc Physical Therapist PastSince Dec 31, 1999 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

1910 Old Tustin Ave
Santa Ana, CA 92705
Phone (714) 835-6638

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1629169701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 OLD TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927057811",
            "telephone_number": "714-835-6638",
            "fax_number": "714-835-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29803 SANTA MARGARITA PKWY",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883609",
            "telephone_number": "949-459-9010",
            "fax_number": "949-459-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "MATTHEW",
        "middle_name": "KURT",
        "credential": "MPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT24650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.