Active NPI
Matthew John Yavorsky, PT, DPT
- Physical Therapist
- Indio, CA
National Provider Identifier
1659731206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT296674
- Practice address
- 81557 Dr Carreon Blvd Ste C4
Indio, CA 92201-5562 - Phone
- (603) 476-1957
- Fax
- (760) 347-2849
- NPI assigned
- Feb 24, 2016
- Last updated
- Mar 23, 2021
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-3953 | ID | |
| Physical Therapist | 225100000X | 11681 | AZ | |
| Physical Therapist | 225100000X | 61452 | OR | |
| Physical Therapist | 225100000X | PT296674 | CA | Primary |
Addresses
Primary practice location
81557 Dr Carreon Blvd Ste C4
Indio, CA 92201-5562
Mailing address
1106 Walnut St Ste 110
San Luis Obispo, CA 93401-2416
Phone (805) 788-0805
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 |
|---|---|---|---|
| 11681 | AZ | MD | Physical Therapist |
| PT296674 | CA | MD | Physical Therapist |
| PT-3953 | ID | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CV Physical Therapy, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Movement For Life Physical Therapy
- Physical Therapy Clinic/Center
- Indio, CA
- NPI 1013167527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616457600000",
"number": "1659731206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1106 WALNUT ST STE 110",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012416",
"telephone_number": "805-788-0805",
"fax_number": "805-788-0845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81557 DR CARREON BLVD STE C4",
"city": "INDIO",
"state": "CA",
"postal_code": "922015562",
"telephone_number": "603-476-1957",
"fax_number": "760-347-2849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAVORSKY",
"first_name": "MATTHEW",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-24",
"last_updated": "2021-03-23",
"certification_date": "2021-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-3953",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "11681",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "61452",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT296674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.