Physical Edge, Inc.
NPI 1770675639ActiveOrganization· Physical Therapist· Davis, CA
Physical Therapist in Davis, California, registered in NPPES in September 2006. The authorized official on file is Mathew Moore, MPT, Owner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1770675639 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 29, 2006 |
| Last updated in NPPES | Mar 13, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 22276 | CA |
| Physical Therapist | 225100000X | 6526 | CA |
| Physical Therapist | 225100000X | 30188 | CA |
| Physical Therapist | 225100000X | 32377 | CA |
| Physical Therapist | 225100000X | 27732 | CA |
| Physical Therapist, Pediatrics | 2251P0200X | PT 16894 | CA |
| Occupational Therapist, Hand | 225XH1200X | 1528 | CA |
| Occupational Therapist, Pediatrics | 225XP0200X | OT 8402 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (CA) |
|---|
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