Individual provider Active NPI

Hazem Matta, DO

  • Diagnostic Radiology Physician
  • Fort Myers, FL
National Provider Identifier
1184916736
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OS14291 Issued in FL
Practice address
14551 Hope Center Loop Ste 100
Fort Myers, FL 33912-4705
Phone
(239) 936-2316
Fax
(239) 936-3099
NPI assigned
May 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X OS14291 FL
Diagnostic Radiology Physician 2085R0202X OS14291 FL Primary

Addresses

Primary practice location

14551 Hope Center Loop Ste 100
Fort Myers, FL 33912-4705

Mailing address

3660 Broadway
Fort Myers, FL 33901-8005
Phone (239) 936-2316

Other practice location 1

500 University Dr
Department of Radiology, H066
Hershey, PA 17033-2360
Phone (717) 531-6896

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170823003458 FL Practitioner - Interventional Radiology 6204108327 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Philadelphia College of Osteopathic Medicine
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proscan NCH Imaging LLCGroup PAC ID 6103233051, 104 clinicians
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians
Radiology Regional Center P aGroup PAC ID 9638151756, 60 clinicians

Practice addresses (Care Compare)

1020 Crosspointe Dr
Suite 103
Naples, FL 34110-0918
Phone (239) 598-0035

13695 US Hwy 1
Sebastian, FL 32958-3230
Phone (904) 399-5550

6101 Pine Ridge Rd
Naples, FL 34119-3900
Phone (904) 399-5550

805 Del Prado N Blvd
Cape Coral, FL 33909
Phone (239) 936-2316

8300 Collier Blvd
Naples, FL 34114-3549
Phone (904) 399-5550

Hospital & facility affiliations

  • Naples Community Hospital Hospital, Naples, FL, CCN 100018
  • Physicians Regional Medical Center - Pine Ridge Hospital, Naples, FL, CCN 100286

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS14291FLMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Regional Center Professional Services LLC Diagnostic Radiology CurrentSince Aug 7, 2017 Accepting new patients
Millennium Physician Group LLC CurrentSince Jan 1, 2024 Accepting new patients
Proscan NCH Imaging LLC Diagnostic Radiology CurrentSince May 8, 2024 Accepting new patients
Millennium Physician Group LLC CurrentSince Jan 1, 2024 Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince May 12, 2025 Accepting new patients
Radiology Regional Center P a Diagnostic Radiology CurrentSince Aug 7, 2017 Accepting new patients
Lucidsolutions, Inc. Diagnostic Radiology CurrentSince Jan 17, 2025 Accepting new patients
Proscan NCH Imaging LLC Diagnostic Radiology CurrentSince May 8, 2024 Accepting new patients
Radiology Regional Center, PA Diagnostic Radiology PastSince Aug 28, 2021 Accepting new patients
Specialists in Diagnostic Imaging PA Diagnostic Radiology Past Accepting new patients
Radiology Regional Center, PA Diagnostic Radiology PastSince Aug 28, 2021 Accepting new patients

Locations

9776 Bonita Beach Rd SE
Bonita Springs, FL 34135
Phone (239) 444-2200

14540 Cortez Blvd
Ste 102
Brooksville, FL 34613
Phone (352) 596-7255

805 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 242-8010

1708 Cape Coral Pkwy W
Ste 3
Cape Coral, FL 33914
Phone (239) 541-3800

10201 Arcos Ave
Ste 101
Estero, FL 33928
Phone (239) 444-5800

3660 Broadway
Fort Myers, FL 33901
Phone (239) 424-1449

6100 Winkler Rd
Fort Myers, FL 33919

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

6100 Winkler Rd
Ste A
Fort Myers, FL 33919
Phone (239) 931-8300

3680 Broadway
Fort Myers, FL 33901
Phone (239) 936-0380

13813 Metro Pkwy
Fort Myers, FL 33912
Phone (239) 936-1343

6140 Winkler Rd
Fort Myers, FL 33919

14551 Hope Center Loop
Ste 100
Fort Myers, FL 33912
Phone (399) 362-3162

1110 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 344-1000

1020 Crosspointe Dr
Ste 103
Naples, FL 34110
Phone (239) 624-4443

700 Goodlette Rd
Naples, FL 34102
Phone (239) 430-1400

1735 SW Health Pkwy
Ste 201
Naples, FL 34109
Phone (239) 249-7800

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

18300 Murdock Cir
Unit 101
Port Charlotte, FL 33948

18300 Murdock Cir
Bldg 15
Port Charlotte, FL 33948
Phone (941) 255-7901

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

6600 University Pkwy
Ste 102
Sarasota, FL 34240
Phone (941) 378-3231

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 11

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.

Hospital & facility affiliations 3

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": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1184916736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 BROADWAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018005",
            "telephone_number": "239-936-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14551 HOPE CENTER LOOP STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124705",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_2": "Department of Radiology, H066",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-6896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTA",
        "first_name": "HAZEM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-13",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "OS14291",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS14291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.