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Matt Wrathall , CM

Physician β€’ Rexburg, ID

Active NPI 1205612405 Individual Practitioner Male Practitioner
Practice location in NPPES

663 Trejo St
Rexburg, ID 834402579

Call 3857584356 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

663 Trejo St

Rexburg, ID 834402579

Telephone 3857584356

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2022

Years since graduation

4 years (graduated 2022)

CMS Doctors and Clinicians data list 2022 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

May accept Medicare assignment

CMS data show this clinician may accept Medicare assignment. Clinicians who do not always accept assignment can decide case by case.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Can order Medicare-covered services

CMS lists Matt Wrathall as eligible to order or refer durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-03-16
Clinic/Center - Pain Primary Specialty

NUCC Taxonomy Code: 261QP3300X

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Idaho State Medical Licensing Board.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Not Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location March 16, 2025

Registered at 663 TREJO ST, REXBURG, ID 834402579 (Tel: 3857584356)

πŸ“
Updated Business Mailing Address January 14, 2024

Registered at PO BOX 151, MENAN, ID 834340151 (Tel: 3857584356)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 14, 2024

Clinic/Center

βœ…
NPI Profile Active September 04, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 04, 2023

Registered at 3672 E MENAN LORENZO HWY, MENAN, ID 834345204 (Tel: 2082206344)

πŸ“
Business Mailing Address (Initial Record) September 04, 2023

Registered at 3672 E MENAN LORENZO HWY, MENAN, ID 834345204 (Tel: 2082206344)

πŸ‘€
Provider Name / Credentials (Initial Record) September 04, 2023

Recorded as MATT WRATHALL, CM

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 04, 2023

Naturopath

🟒
Initial NPI Registration & Enumeration September 04, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1205612405
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 04, 2023
Last Update: March 16, 2025
Sole Proprietor: Yes

Mailing Address

Po Box 151

Menan, ID 834340151

Phone: 3857584356

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.