Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Matthew Quinn Ezernack

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1912699547

Matthew Quinn Ezernack is a Physical Therapist in Private Practice in Lake Charles, Louisiana. Qualified in 2023, 3 years ago. Practices with Calcasieu Therapy Group LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
3
Licensed in
LA
In the registry since
2023
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Practice location Address checks out

4080 Nelson Rd Ste 500
Lake Charles, LA 70605-2440
Phone: (337) 494-7546
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 11530 (LA)

Record details

NPI number1912699547
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 23, 2023
Last updated in NPPESMay 23, 2023
Certification dateMay 23, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Calcasieu Therapy Group Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Lake Charles