Individual provider Active NPI

Wilmer Neptali Mata, M.D.

  • Surgery Physician
  • Miami, FL
National Provider Identifier
1104168509
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME134812 Issued in FL
Practice address
15955 SW 96TH St Ste 102
Miami, FL 33196
Phone
(786) 467-3435
Fax
(786) 533-9383
NPI assigned
Mar 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME134812 FL Primary

Addresses

Primary practice location

15955 SW 96TH St Ste 102
Miami, FL 33196

Mailing address

PO Box 198054
Atlanta, GA 30384-8054

Other practice location 1

2001 W 86th St
Indianapolis, IN 46260-1902
Phone (317) 338-2281

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
I20190808002570 FL Practitioner - General Surgery 5698066298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group Physicians LLCGroup PAC ID 3870696933, 661 clinicians

Practice addresses (Care Compare)

15955 SW 96TH St
Suite 102
Miami, FL 33196-1272
Phone (786) 467-3435

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as apm
Quality
81.94
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME134812FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Physicians LLC CurrentSince Sep 9, 2019 Accepting new patients

Locations

8400 NW 53rd St
Ste F104
Miami, FL 33166
Phone (786) 595-9900

15955 SW 96th St
Ste 102
Miami, FL 33196
Phone (786) 467-3140

6200 Sunset Dr
Ste 604
South Miami, FL 33143
Phone (305) 853-9240

Interoperability endpoints

  • Direct secure messaging: wil19837@cerner.directbaptisthealth.com

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1363996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1104168509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198054",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15955 SW 96TH ST STE 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33196",
            "telephone_number": "786-467-3435",
            "fax_number": "786-533-9383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 W 86th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601902",
            "country_code": "US",
            "telephone_number": "317-338-2281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATA",
        "first_name": "WILMER",
        "middle_name": "NEPTALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-23",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME134812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.