Individual provider Active NPI

Justin Strittmatter, MD

  • Emergency Medicine Physician
  • Panama City, FL
National Provider Identifier
1033198965
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME0092292 Issued in FL
Practice address
615 N Bonita Ave
Emergency Department
Panama City, FL 32401-3623
Phone
(850) 747-6000
Fax
(850) 747-6323
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME0092292 FL Primary

Addresses

Primary practice location

615 N Bonita Ave
Emergency Department
Panama City, FL 32401-3623

Mailing address

PO Box 9167
Panama City Beach, FL 32417-9167
Phone (850) 665-3653

Other identifiers 3

IdentifierTypeStateIssuer
254305183AMedicaidGA
52413OtherFLBCBS
271626700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040826000841 LA Practitioner - Emergency Medicine 0244205011 Reassigns benefits to 2 organizations
I20200226002324 MS Practitioner - Emergency Medicine 0244205011 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0092292FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Emergency Group LLC Emergency Medicine CurrentSince Mar 12, 2018 Accepting new patients
Delta Medical Group Emergency Medicine CurrentSince Dec 20, 2019 Accepting new patients
St Tammany Emergency Physicians Group LLC Emergency Medicine CurrentSince Apr 21, 2015 Accepting new patients
Emergency Providers Group LLC Emergency Medicine Past Accepting new patients
Delta Physician Practices Past Accepting new patients
Gulf Emergency Specialists PA Emergency Medicine Past Accepting new patients

Locations

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

1125 Marguerite St
Morgan City, LA 70380
Phone (985) 380-4434

1693 Fairgrounds Rd
Greenville, MS 38703
Phone (662) 378-3783

401 Getwell Dr
Senatobia, MS 38668
Phone (662) 562-3100

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1033198965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9167",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324179167",
            "telephone_number": "850-665-3653",
            "fax_number": "850-665-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N BONITA AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013623",
            "telephone_number": "850-747-6000",
            "fax_number": "850-747-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRITTMATTER",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME0092292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254305183A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52413",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271626700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.