Active NPI
Daniel De Fazio Mathews, D.P.M.
- Foot Surgery Podiatrist
- Boca Raton, FL
National Provider Identifier
1184731739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- 4494
- Practice address
- 3196 N Federal Hwy
Boca Raton, FL 33431-6700 - Phone
- (561) 849-3000
- Fax
- (800) 708-1338
- NPI assigned
- Aug 23, 2006
- Last updated
- Oct 14, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | ||
| Foot Surgery Podiatrist | 213ES0131X | 4494 | FL | Primary |
| Foot Surgery Podiatrist | 213ES0131X | 004379 | NY |
Addresses
Primary practice location
3196 N Federal Hwy
Boca Raton, FL 33431-6700
Mailing address
11 Plaza Real S Apt 1212
Boca Raton, FL 33432-4869
Phone (203) 442-3121
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: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4494 | FL | MD | Foot Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Usai Med LLC | Current | Accepting new patients | |
| Anti-Aging Alliance LLC | Past | Accepting new patients |
Locations
3196 N Federal Hwy
Ste A
Boca Raton, FL 33431
Phone (561) 445-4489
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697241600000",
"number": "1184731739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 PLAZA REAL S APT 1212",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334324869",
"telephone_number": "203-442-3121",
"fax_number": "800-708-1338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3196 N FEDERAL HWY",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334316700",
"telephone_number": "561-849-3000",
"fax_number": "800-708-1338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEWS",
"first_name": "DANIEL",
"middle_name": "DE FAZIO",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2023-10-14",
"certification_date": "2023-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "FL",
"license": "4494",
"primary": true
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "NY",
"license": "004379",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.