Active NPI
Matthew Legasse, CO
- Orthotist
- Stockton, CA
National Provider Identifier
1770899460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- Practice address
- 1236 N El Dorado St Ste Abc
Stockton, CA 95202-1324 - Phone
- (209) 944-5517
- NPI assigned
- Aug 19, 2010
- 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 |
|---|---|---|---|---|
| Orthotist | 222Z00000X | Primary |
Addresses
Primary practice location
1236 N El Dorado St Ste Abc
Stockton, CA 95202-1324
Mailing address
1236 N El Dorado St Ste Abc
Stockton, CA 95202-1324
Phone (209) 944-5517
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282176000000",
"number": "1770899460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1236 N EL DORADO ST STE ABC",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952021324",
"telephone_number": "209-944-5517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1236 N EL DORADO ST STE ABC",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952021324",
"telephone_number": "209-944-5517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGASSE",
"first_name": "MATTHEW",
"credential": "CO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-19",
"last_updated": "2010-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.