Individual provider Active NPI

Matthew Greenberg, DPT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1992951610
Registry record updated Feb 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1940 Issued in NV
Practice address
6440 Medical Center St Ste 100
Las Vegas, NV 89148-2404
Phone
(702) 222-1000
Fax
(702) 222-9448
NPI assigned
Aug 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2018

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 1940 NV Primary

Addresses

Primary practice location

6440 Medical Center St Ste 100
Las Vegas, NV 89148-2404

Mailing address

6440 Medical Center St Ste 100
Las Vegas, NV 89148-2404
Phone (702) 222-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090203000740 NV Practitioner - Physical Therapist in Private Practice 6800950924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Executive Fitness IncGroup PAC ID 9638158884, 5 clinicians

Practice addresses (Care Compare)

6440 Medical Ctr St
Suite 100
Las Vegas, NV 89148-2404
Phone (702) 222-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1940NVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Executive Fitness Inc Physical Therapist CurrentSince Mar 9, 2018 Accepting new patients
Rapid Rehab & Wellness Center, Inc. Physical Therapist CurrentSince Jan 30, 2012 Accepting new patients
Executive Fitness Inc PastSince Jul 18, 2010 Accepting new patients

Locations

2779 W Horizon Ridge Pkwy
Ste 100
Henderson, NV 89052
Phone (702) 222-1000

8751 W Charleston Blvd
Las Vegas, NV 89117
Phone (702) 982-2232

6440 Medical Center St
Ste 100
Las Vegas, NV 89148
Phone (702) 222-1000

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": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1992951610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6440 MEDICAL CENTER ST STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891482404",
            "telephone_number": "702-222-1000",
            "fax_number": "702-222-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 MEDICAL CENTER ST STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891482404",
            "telephone_number": "702-222-1000",
            "fax_number": "702-222-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-13",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; 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.