Individual provider Active NPI

Matthew J Mifsud, MD

  • Otolaryngology Physician
  • Tampa, FL
National Provider Identifier
1285953679
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME132370 Issued in FL
Practice address
2 Tampa General Cir FL Circle2
Tampa, FL 33606-3603
Phone
(813) 974-4683
NPI assigned
May 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME132370 FL Primary

Addresses

Primary practice location

2 Tampa General Cir FL Circle2
Tampa, FL 33606-3603

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other practice location 1

401-600 University Avenue
Toronto, Ontario M5S1Z6
CA
Phone (416) 586-5141

Other identifiers 2

IdentifierTypeStateIssuer
021425700MedicaidFL
VSOT1OtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmifsud113838@direct.tgh.org

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
I20170811001857 FL Practitioner - Otolaryngology 3971874793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Tufts University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Medical Service Association IncGroup PAC ID 6800790221, 818 clinicians

Practice addresses (Care Compare)

13330 Usf Laurel Dr
Tampa, FL 33612-6601

4202 E Fowler Ave
Tampa, FL 33620-6750

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Jun 27, 2017 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc Current Accepting new patients
University Medical Service Association Inc Otolaryngology CurrentSince Jun 27, 2017 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

2 Tampa General Cir
Tampa, FL 33606
Phone (813) 259-8700

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

13330 Usf Laurel Dr
Tampa, FL 33612
Phone (813) 396-9478

13330 Usf Laurel Dr
Fl 3
Tampa, FL 33612
Phone (813) 396-9422

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: matthew.mifsud@direct.moffitt.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

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 1

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": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1285953679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TAMPA GENERAL CIR FL CIRCLE2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063603",
            "telephone_number": "813-974-4683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401-600 University Avenue",
            "address_purpose": "LOCATION",
            "city": "Toronto",
            "state": "Ontario",
            "postal_code": "M5S1Z6",
            "country_code": "CA",
            "telephone_number": "416-586-5141",
            "country_name": "Canada",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "MIFSUD",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-25",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME132370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021425700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "VSOT1",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmifsud113838@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir Fl Circle2",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.