MATTHEW WAYNE MOOBERRY (MA SLP) – Speech-Language Pathologist, NPI 1023996741

MATTHEW WAYNE MOOBERRY (MA SLP) is a healthcare provider. based in Rancho cucamonga, California. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold the professional credentials MA SLP. They hold a License No. PSLP.0001474 (CO). The NPI Number for MATTHEW WAYNE MOOBERRY (MA SLP) is 1023996741

Main info

Male
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
MATTHEW WAYNE MOOBERRY (MA SLP)
NPI
1023996741
Phone
(909) 731-7965
Address
10656 RING AVE
Enumeration Date
21 August 2025
Last Update Date
21 August 2025

Doctor Profile

Medical School Name
UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, DENVER
Secondary Phone
3039635582
Graduation Year
2025 (1 year ago)
PAC ID
8325540131
Group Practice PAC ID
9032521448
Professional Enrollment ID
I20250909001967
Address ID
CO800272318LO1371XDRXX304
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

209 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in CO

Provider Addresses for MATTHEW WAYNE MOOBERRY (MA SLP)

  • 10656 RING AVE

    RANCHO CUCAMONGA, CA 917374416

    Phone: (909) 731-7965

    Type: Mailing

  • 1371 HECLA DR STE D130

    LOUISVILLE, CO 800272318

    Phone: (303) 963-5582

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250909001967IQualified Speech Language PathologistCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91737)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032521448View full group profile
NameSpecialtyState
Qualified Speech Language PathologistND
Physical Therapist In Private PracticeCO
Occupational Therapist In Private PracticeCO
Occupational Therapist In Private PracticeCO
Qualified Speech Language PathologistCO
Qualified Speech Language PathologistCO
Physical Therapist In Private PracticeCO
Occupational Therapist In Private PracticeCO
Occupational Therapist In Private PracticeCO
Qualified Speech Language PathologistCO

Reviews

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Frequently asked questions

Does MATTHEW WAYNE MOOBERRY (MA SLP) have a public NPI I can cite?
Public records show MATTHEW WAYNE MOOBERRY (MA SLP) under NPI 1023996741.
Is MATTHEW WAYNE MOOBERRY (MA SLP)'s NPI status active today?
Active status means MATTHEW WAYNE MOOBERRY (MA SLP)'s NPI record is not deactivated in the public file.
What services align with MATTHEW WAYNE MOOBERRY (MA SLP)'s listing?
MATTHEW WAYNE MOOBERRY (MA SLP)'s public classification highlights Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
Which community is linked to MATTHEW WAYNE MOOBERRY (MA SLP)?
MATTHEW WAYNE MOOBERRY (MA SLP) shows a connection to Rancho Cucamonga, California in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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