Matt T Neibaur, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME50819 Issued in FL

Practice address

1995 US 1 South
St Augustine, FL 32086

Phone

(850) 242-9316

NPI assigned

Jul 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1124044664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 WINDJAMMER LN",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845218",
            "telephone_number": "850-242-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 US 1 SOUTH",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32086",
            "telephone_number": "850-242-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIBAUR",
        "first_name": "MATT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME50819",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME50819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Neal
• Denise J Nealey, MS
• Laila Benzakour Needham, MD
• Suhas P Neerukonda, MD
• Emanuela Negrescu, DMD
• Amanda Vanessa Neira
• Russell W Nelligan, MD
• Diamond Ann Nelson
• Joanna Nelson, MPH
• Marcia M Nemecek, DMD

• Internal Medicine Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.