Active NPI
Matthew S Dedoes, P.T.
- Physical Therapist
- Redlands, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT25116
- Practice address
- 245 Terracina Blvd
Suite 105
Redlands, CA 92373-4852 - Phone
- (909) 792-9737
- Fax
- (909) 796-4158
- NPI assigned
- Jul 11, 2006
- 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 | PT25116 | CA | Primary |
Addresses
Primary practice location
245 Terracina Blvd
Suite 105
Redlands, CA 92373-4852
Mailing address
PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 335-4188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthcare Partners Affiliates Medical Group | Current | Accepting new patients | |
| Beaver Medical Group P C | Current | Accepting new patients | |
| Beaver Medical Group P C | Physical Therapist | Current | Accepting new patients |
| Healthcare Partners Affiliates Medical Group | Current | Accepting new patients | |
| Healthcare Partners Affiliates Medical Group | Current | Accepting new patients | |
| Beaver Medical Group P C | Past | Accepting new patients |
Locations
1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000
5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864
824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706
1615 Orange Tree Ln
Redlands, CA 92374
Phone (909) 335-4102
2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137
2 W Fern Ave
#1112
Redlands, CA 92373
245 Terracina Blvd
Ste 105
Redlands, CA 92373
Phone (909) 335-4102
1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Redlands, CA
- NPI 1649503319
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1659312593
-
- Physical Therapist
- Redlands, CA
- NPI 1427090281
-
- Durable Medical Equipment & Medical Supplies
- Murrieta, CA
- NPI 1760057269
-
- Addiction Medicine (Internal Medicine) Physician
- Tustin, CA
- NPI 1891981502
-
- Family Medicine Physician
- Redlands, CA
- NPI 1275570830
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583971200000",
"number": "1710912522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10069",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924230069",
"telephone_number": "909-335-4188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 TERRACINA BLVD",
"address_2": "SUITE 105",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923734852",
"telephone_number": "909-792-9737",
"fax_number": "909-796-4158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEDOES",
"first_name": "MATTHEW",
"middle_name": "S",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2020-03-12",
"certification_date": "2020-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT25116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.