Matthew Jordan Stark, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME143181 Issued in FL

Practice address

2600 N Military TRL Ste 355
Boca Raton, FL 33431-6312

Phone

(561) 510-9150

Fax

(561) 600-9655

NPI assigned

Mar 22, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 2, 2022 through May 2, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Doctor Sam, LLC

  • Psychiatry Physician
  • Boca Raton, FL
  • NPI 1407495575
  NPD

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1194187963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 N MILITARY TRL STE 355",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316312",
            "telephone_number": "561-510-9150",
            "fax_number": "561-600-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N MILITARY TRL STE 355",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316312",
            "telephone_number": "561-510-9150",
            "fax_number": "561-600-9655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "305-355-8264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARK",
        "first_name": "MATTHEW",
        "middle_name": "JORDAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2021-04-01",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME143181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Vincent Stanzione, DPT
• Star Care Health Providers of America PLLC
• Star Medical FL PLLC
• Starbridge Physician Care
• Julie L. Stark, MSW, LCSW
• Dawn Marci Starkman, M.S.,CCC-SLP
• Starr Medical Supplies, Inc.
• Cortlyn Andrew Hugh Starr, MPH, OTD
• Stephanie Mann Starr, LCSW
• Susan Lynn Starr, LCSW

• Psychiatry Physician in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.