Individual provider Active NPI

Matthew Phillip Stroud, PA

  • Physician Assistant
  • Celebration, FL
National Provider Identifier
1164917910
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111337 Issued in FL
Practice address
410 Celebration PL Ste 305
Celebration, FL 34747-5436
Phone
(407) 303-4120
Fax
(407) 303-4124
NPI assigned
Jun 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111337 FL Primary

Addresses

Primary practice location

410 Celebration PL Ste 305
Celebration, FL 34747-5436

Mailing address

410 Celebration PL Ste 305
Celebration, FL 34747-5436
Phone (407) 303-4120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241210000907 NY Practitioner - Physician Assistant 5799029567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4000

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

360 Linden Oaks
Suite 300
Rochester, NY 14625-2814
Phone (585) 383-8830

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9111337FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C CurrentSince Oct 5, 2024 Accepting new patients
Rochester General Hospital CurrentSince Oct 5, 2024 Accepting new patients
Rochester General Hospital CurrentSince Oct 5, 2024 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Oct 5, 2024 Accepting new patients

Locations

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Organizations & group practices 5

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1164917910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL STE 305",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475436",
            "telephone_number": "407-303-4120",
            "fax_number": "407-303-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL STE 305",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475436",
            "telephone_number": "407-303-4120",
            "fax_number": "407-303-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROUD",
        "first_name": "MATTHEW",
        "middle_name": "PHILLIP",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.