Individual provider Active NPI

Katie Lou Matteuzzi, DO

  • Emergency Medicine Physician
  • Eglin Afb, FL
National Provider Identifier
1063971075
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS19359 Issued in FL
Practice address
340 Boatner Rd
Eglin Afb, FL 32542-1391
Phone
(850) 883-8227
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0102206450 VA
General Practice Physician 208D00000X 0102206450 VA
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X OS19359 FL Primary

Addresses

Primary practice location

340 Boatner Rd
Eglin Afb, FL 32542-1391

Mailing address

340 Boatner Rd
Eglin Afb, FL 32542-1391
Phone (850) 883-8227

Other names 1

  • Katie Lou Priestley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231115003990 FL Practitioner - Emergency Medicine 2466836549 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

7800 US Hwy 98 W
Miramar Beach, FL 32550-7228
Phone (850) 278-3000

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS19359FLMDEmergency Medicine Physician
0102206450VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Floridian Emergency Specialists, LLC Emergency Medicine CurrentSince Dec 23, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Dec 1, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Dec 1, 2023 Accepting new patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Aug 5, 2023 Accepting new patients
Floridian Emergency Specialists LLC Emergency Medicine Current Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

2190 Highway 85 N
Niceville, FL 32578
Phone (850) 678-4131

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1063971075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-8227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTEUZZI",
        "first_name": "KATIE",
        "middle_name": "LOU",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102206450",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102206450",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS19359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "PRIESTLEY",
            "middle_name": "LOU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eglin Afb, FL

Sources for this page

Verify at the official NPI Registry.