Individual provider Active NPI

Matthew P Fain, PT

  • Physical Therapist
  • Spokane, WA
National Provider Identifier
1982700563
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT9873 Issued in WA
Practice address
10208 N Division St
Suite 102
Spokane, WA 99218-1569
Phone
(509) 465-5400
Fax
(509) 465-5401
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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 PT9873 WA Primary

Addresses

Primary practice location

10208 N Division St
Suite 102
Spokane, WA 99218-1569

Mailing address

1215 N McDonald Rd
Suite L2
Spokane Valley, WA 99216-1557
Phone (509) 893-4462

Other identifiers 1

IdentifierTypeStateIssuer
8437410MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051017001036 WA Practitioner - Physical Therapist in Private Practice 8426074600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Texas Tech University Health Science Center School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phase 1 Physical Therapy PSGroup PAC ID 2860595071, 3 clinicians

Practice addresses (Care Compare)

6066 Hwy 291
Nine Mile Falls, WA 99026-5008
Phone (509) 465-5663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT9873WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Physical Therapy and Spine Rehabilitation Inc Physical Therapist Past Accepting new patients
Thunder Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients
Whitworth Physical Therapy, PS Physical Therapist Past Accepting new patients

Organizations & group practices 4

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1982700563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 N MCDONALD RD",
            "address_2": "SUITE L2",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161557",
            "telephone_number": "509-893-4462",
            "fax_number": "509-893-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10208 N DIVISION ST",
            "address_2": "SUITE 102",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181569",
            "telephone_number": "509-465-5400",
            "fax_number": "509-465-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIN",
        "first_name": "MATTHEW",
        "middle_name": "P",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT9873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8437410",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.