Corey Samudosky, PT, DPT
NPI 1386415172ActiveIndividual· Physical Therapist, Orthopedic· Decatur, TX
Physical Therapist, Orthopedic (PT, DPT) with Bonnette Elite Physical Therapy and Wellness, practicing in Decatur, Texas. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1386415172 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT, DPT |
| Sole proprietor | No |
| NPI issued | Jan 11, 2024 |
| Last updated in NPPES | Feb 29, 2024 |
| Certified by provider | Feb 29, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist, Orthopedic Primary | 2251X0800X | 1373953 | TX |
| Physical Therapist, Sports | 2251S0007X | 1373953 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (TX) |
|---|
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Bonnette Elite Physical Therapy and WellnessFort Worth, TX · 12 clinicians
Other orthopedic physical therapists in Decatur
- 1790265528