Individual provider Active NPI

Matthew D Walker, PT

  • Physical Therapist
  • Stockton, CA
National Provider Identifier
1982120127
Registry record updated Aug 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT293570 Issued in CA
Practice address
1716 W Hammer LN
Stockton, CA 95209-2922
Phone
(209) 473-2383
Fax
(209) 473-1350
NPI assigned
Aug 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2017

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 PT293570 CA Primary

Addresses

Primary practice location

1716 W Hammer LN
Stockton, CA 95209-2922

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
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170907001329 CA Practitioner - Physical Therapist in Private Practice 5092088427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
67.73 of 100Reported as group
Quality
41.21
Improvement activities
40
Cost
83.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT293570CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Apr 5, 2021 Accepting new patients
Gold Country Therapies, Inc PastSince Jan 1, 2015 Accepting new patients

Locations

1229 Commerce Ave
Atwater, CA 95301
Phone (209) 683-1386

1335 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 576-1946

1222 W Colony Rd
Ste 130
Ripon, CA 95366
Phone (209) 624-1288

1906 Vista del Lago Dr
Ste A
Valley Springs, CA 95252
Phone (209) 772-0848

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": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503014400000",
    "number": "1982120127",
    "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": "1716 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092922",
            "telephone_number": "209-473-2383",
            "fax_number": "209-473-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-18",
        "last_updated": "2017-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT293570",
            "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 18, 2017; 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.