Individual provider Active NPI

Cindy M Nazario- Matos, M.D.

  • Pediatrics Physician
  • Titusville, FL
National Provider Identifier
1306882642
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ACN949 Issued in FL
Practice address
500 N Washington Ave Ste 105
Titusville, FL 32796-2759
Phone
(321) 268-0267
Fax
(321) 268-3357
NPI assigned
Jun 22, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2010006918 MO
Pediatrics Physician 208000000X ACN949 FL Primary
Pediatrics Physician 208000000X 13467 PR

Addresses

Primary practice location

500 N Washington Ave Ste 105
Titusville, FL 32796-2759

Mailing address

PO Box 1137
Melbourne, FL 32902-1137
Phone (321) 952-9696

Other practice location 1

1012 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-0330

Other identifiers 1

IdentifierTypeStateIssuer
021690500MedicaidFL

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
I20171213001651 FL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7719298066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010006918MOMDPediatrics Physician
13467PRMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: cindy.naraziomatos@bha.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1306882642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329021137",
            "telephone_number": "321-952-9696",
            "fax_number": "321-952-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N WASHINGTON AVE STE 105",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962759",
            "telephone_number": "321-268-0267",
            "fax_number": "321-268-3357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1012 N Main St",
            "address_purpose": "LOCATION",
            "city": "Sikeston",
            "state": "MO",
            "postal_code": "638015044",
            "country_code": "US",
            "telephone_number": "573-471-0330",
            "fax_number": "573-472-2966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAZARIO- MATOS",
        "first_name": "CINDY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2010006918",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ACN949",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "13467",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021690500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.