Matthew Ryan Deboer, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS10998 Issued in FL

Practice address

1310 County Road 210 W
Saint Johns, FL 32259

Phone

(904) 824-4407

Fax

(904) 390-7459

NPI assigned

May 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250

Merit-based Incentive Payment System (MIPS)

Final score

95.44 of 100Reported as apm

Quality

84.21

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdeboer28183@baptisthealthsystemjacksonville.direct-ci.com

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.

• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1508817529
  Medicare reassignment Care Compare group NPD
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1013160704
  NPD

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

• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation
• Champlain Valley Physicians Hospital Medical Center

  • General Acute Care Hospital
  • Plattsburgh, NY
  • NPI 1033270699
  Care Compare affiliation

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1104047893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 COUNTY ROAD 210 W",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "32259",
            "telephone_number": "904-824-4407",
            "fax_number": "904-390-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOER",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS10998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00855555",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Javier Davila, M.D.
• Carmen Cristina Davis, FNP-C
• Rhonda Joyce Davis
• Leslie Jones De Jong, PT
• Nicholas Joseph Dean-Andrews, BCBA
• Theressa Demostene
• Dennis Stone, M.D., P.a.
• Developing Growth Again, LLC
• Diabetic Medical Concepts, Inc.
• Diabetic Services & Supplies Inc

• Family Medicine Physician in Saint Johns, FL
• Providers in Saint Johns, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.