Individual provider Active NPI

Matthew James Palicka, ARNP

  • Family Nurse Practitioner
  • Naples, FL
National Provider Identifier
1144339383
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5018574 Issued in NC
Practice address
399 9TH St N
Suite 300
Naples, FL 34102-5820
Phone
(239) 436-5634
Fax
(239) 649-1290
NPI assigned
Aug 30, 2006
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP3209042 FL
Family Nurse Practitioner 363LF0000X 5018574 NC Primary

Addresses

Primary practice location

399 9TH St N
Suite 300
Naples, FL 34102-5820

Mailing address

6101 Pine Ridge Rd
Desk 12/13
Naples, FL 34119-3900
Phone (239) 263-0849

Other practice location 1

2201 S Sterling St
Morganton, NC 28655-4044
Phone (828) 580-5000

Other identifiers 2

IdentifierTypeStateIssuer
002474000MedicaidFL
YQ4QTOtherFLBCBS FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100807000050 FL Practitioner - Nurse Practitioner 5294868592 Reassigns benefits to 1 organization
I20240329002510 NC Practitioner - Nurse Practitioner 5294868592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Naples Heart Rhythm Specialists PAGroup PAC ID 8729177035, 21 clinicians

Practice addresses (Care Compare)

2201 S Sterling St
Morganton, NC 28655-4044
Phone (828) 580-6393

6376 Pine Ridge Rd
Naples, FL 34119-3926
Phone (239) 263-0849

730 Goodlette Rd N
Suite 100
Naples, FL 34102-5617
Phone (239) 682-6603

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5018574NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. Current Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Naples Heart Rhythm Specialists PA CurrentSince Jun 1, 2016 Accepting new patients
Lower Keys Inpatient Services, LLC Past Accepting new patients
Comprehensive Hospitalist Services of Naples LLC Past Accepting new patients

Locations

6101 Pine Ridge Rd
#1213
Naples, FL 34119
Phone (239) 263-0849

730 Goodlette Rd
Ste 100
Naples, FL 34102
Phone (239) 263-0849

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25641/brand/1/csg/1/fhir/r4
  • Direct secure messaging: matthew.palicka.1@25641.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1144339383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 PINE RIDGE RD",
            "address_2": "DESK 12/13",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341193900",
            "telephone_number": "239-263-0849",
            "fax_number": "239-263-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 9TH ST N",
            "address_2": "SUITE 300",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025820",
            "telephone_number": "239-436-5634",
            "fax_number": "239-649-1290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 S Sterling St",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286554044",
            "country_code": "US",
            "telephone_number": "828-580-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALICKA",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3209042",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5018574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002474000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "YQ4QT",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.