Individual provider Active NPI

Daniel Patrick Mattimore, MD

  • Anesthesiology Physician
  • Durham, NC
National Provider Identifier
1073190344
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME179738 Issued in FL
Practice address
Dumc 3094
Durham, NC 27710-0001
Phone
(919) 684-8111
NPI assigned
Mar 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 2025-01436 NC
Anesthesiology Physician 207L00000X ME179738 FL Primary

Addresses

Primary practice location

Dumc 3094
Durham, NC 27710-0001

Mailing address

2815 S Seacrest Blvd
Boynton Beach, FL 33435-7969

Other practice location 1

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-2975

Other practice location 2

2815 S Seacrest Blvd
Boynton Beach, FL 33435-7995
Phone (561) 737-7733

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
I20260624001877 FL Practitioner - Anesthesiology 1658886536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Tufts University School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1525 NW 62ND St
Fort Lauderdale, FL 33309-1831

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME179738FLMDAnesthesiology Physician

Organizations & group practices 1

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": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1073190344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 S SEACREST BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DUMC 3094",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100001",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Nicolls Rd",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117940001",
            "country_code": "US",
            "telephone_number": "631-444-2975",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2815 S Seacrest Blvd",
            "address_purpose": "LOCATION",
            "city": "Boynton Beach",
            "state": "FL",
            "postal_code": "334357995",
            "country_code": "US",
            "telephone_number": "561-737-7733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTIMORE",
        "first_name": "DANIEL",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2025-01436",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME179738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.