Individual provider Active NPI

Matthew Earhart, PA-C

  • Physician Assistant
  • Boca Raton, FL
National Provider Identifier
1174992465
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108938 Issued in FL
Practice address
9980 Central Park Blvd N Ste 222
Boca Raton, FL 33428-1704
Phone
(561) 558-8898
Fax
(561) 558-8868
NPI assigned
Sep 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PAT 9108938 FL
Surgical Physician Assistant 363AS0400X PA 9108938 FL
Physician Assistant 363A00000X PA9108938 FL Primary

Addresses

Primary practice location

9980 Central Park Blvd N Ste 222
Boca Raton, FL 33428-1704

Mailing address

9980 Central Park Blvd N Ste 222
Boca Raton, FL 33428-1704
Phone (561) 558-8898

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151123000227 FL Practitioner - Physician Assistant 1759681885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Howard J. Gelb MD PAGroup PAC ID 4183664063, 7 clinicians

Practice addresses (Care Compare)

9980 Central Park Blvd N
Boca Raton, FL 33428-1704
Phone (561) 558-8898

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9108938FLMDSurgical Physician Assistant
PAT 9108938FLMDSurgical Physician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1174992465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9980 CENTRAL PARK BLVD N STE 222",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334281704",
            "telephone_number": "561-558-8898",
            "fax_number": "561-558-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9980 CENTRAL PARK BLVD N STE 222",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334281704",
            "telephone_number": "561-558-8898",
            "fax_number": "561-558-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARHART",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-17",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PAT 9108938",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA 9108938",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.