Charlie Mata, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN11033142 Issued in FL

Practice address

4725 N. Federal Hwy
Fort Lauderdale, FL 33308-4603

Phone

(954) 771-8000

NPI assigned

Feb 24, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holy Cross Hospital IncGroup PAC ID 1850298365, 299 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Holy Cross Hospital Inc

  • Internal Medicine Physician
  • Ft. Lauderdale, FL
  • NPI 1467401877
  Medicare reassignment Care Compare group NPD
• Holy Cross Hospital, Inc

  • Health & Wellness Coach
  • Oakland Park, FL
  • NPI 1063207595
  NPD
• Holy Cross Hospital, Inc

  • Anesthesiology Physician
  • Fort Lauderdale, FL
  • NPI 1487405718

  Nurse Anesthetist, Certified Registered

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holy Cross Hospital Inc

  • Internal Medicine Physician
  • Ft. Lauderdale, FL
  • NPI 1467401877

  Hospital

  Care Compare affiliation
• Holy Cross Hospital Inc

  • General Acute Care Hospital
  • Ft Lauderdale, FL
  • NPI 1639197395
  Care Compare affiliation
• Holy Cross Hospital, Inc.

  • Urgent Care Clinic/Center
  • Boca Raton, FL
  • NPI 1376953125

  Hospital

  Care Compare affiliation
• Holy Cross Hospital, Inc.

  • Urgent Care Clinic/Center
  • Fort Lauderdale, FL
  • NPI 1386985190

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1013663343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 HOGBACK RD",
            "address_2": "SUITE 5A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-263-2414",
            "fax_number": "734-773-3471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 N. FEDERAL HWY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084603",
            "telephone_number": "954-771-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA",
        "first_name": "CHARLIE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-24",
        "last_updated": "2025-02-21",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9347349",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11033142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124611300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Massage Therapy by Rina Richard Inc.
• Abir Ali Massri, DDS
• Master Home Health Care, LLC.
• Jason Mastrian, L.M.T
• Richard K Mastrole
• Fernando V. Mata, M.D.
• Joselyn M Mateo, MD
• Rejoy Mathai, APRN
• Smitha Mathew, PHARMD
• Jean-Wilner Mathieu, M.D.

• Certified Registered Nurse Anesthetist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.