Individual provider Active NPI

Matthew Ruane, PT

  • Physical Therapist
  • Los Osos, CA
National Provider Identifier
1922477751
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 25012 Issued in CA
Practice address
1072 Los Osos Valley Rd
Los Osos, CA 93402-3237
Phone
(805) 528-2590
NPI assigned
Sep 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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 PT 25012 CA Primary

Addresses

Primary practice location

1072 Los Osos Valley Rd
Los Osos, CA 93402-3237

Mailing address

1315 5TH St
Los Osos, CA 93402-1210
Phone (805) 528-5344

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041207001227 CA Practitioner - Physical Therapist in Private Practice 5698731008 Reassigns benefits to 1 organization

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
Ruane Family PartnershipGroup PAC ID 0547566580, 3 clinicians

Practice addresses (Care Compare)

1320 Van Beurden Dr
Suite 103
Los Osos, CA 93402-3381
Phone (805) 528-2590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 25012CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ruane Family Partnership Physical Therapist CurrentSince Nov 1, 2015 Accepting new patients
Active Physical Therapy Inc Physical Therapist Past Accepting new patients
Active Physical Therapy, Inc Physical Therapist PastSince Aug 15, 2003 Accepting new patients

Locations

1320 Van Beurden Dr
Ste 103
Los Osos, CA 93402
Phone (805) 242-1360

1072 Los Osos Valley Rd
Los Osos, CA 93402
Phone (805) 528-2590

Organizations & group practices 3

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": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1922477751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 5TH ST",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "934021210",
            "telephone_number": "805-528-5344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 LOS OSOS VALLEY RD",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "934023237",
            "telephone_number": "805-528-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUANE",
        "first_name": "MATTHEW",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 25012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Osos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.