Individual provider Active NPI

Matthew Soileau, P.T.

  • Physical Therapist
  • Conroe, TX
National Provider Identifier
1821274747
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1177090 Issued in TX
Practice address
1501 River Pointe Dr
Suite 130
Conroe, TX 77304-2656
Phone
(936) 756-0086
Fax
(936) 756-0085
NPI assigned
Jan 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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 1177090 TX Primary

Addresses

Primary practice location

1501 River Pointe Dr
Suite 130
Conroe, TX 77304-2656

Mailing address

1501 River Pointe Dr
Suite 130
Conroe, TX 77304-2656
Phone (936) 756-0086

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080402000289 TX Practitioner - Physical Therapist in Private Practice 7911084991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alan C. ThorellGroup PAC ID 2264471457, 4 clinicians

Practice addresses (Care Compare)

20873 C Eva St
Montgomery, TX 77356-1975

20873 Eva St C
Montgomery Physical Therapy
Montgomery, TX 77356-1975
Phone (936) 597-5323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1177090TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apt Enterprises, LLC Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1821274747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 RIVER POINTE DR",
            "address_2": "SUITE 130",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042656",
            "telephone_number": "936-756-0086",
            "fax_number": "936-756-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 RIVER POINTE DR",
            "address_2": "SUITE 130",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042656",
            "telephone_number": "936-756-0086",
            "fax_number": "936-756-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOILEAU",
        "first_name": "MATTHEW",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1177090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.