Active NPI
Neil S Matta, L.D.O
- Optician
- St Petersburg, FL
National Provider Identifier
1316396070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO3942
- Practice address
- 300 Beach Dr NE Ste 115
St Petersburg, FL 33701-3403 - Phone
- (727) 800-5535
- Fax
- (727) 350-3928
- NPI assigned
- Jun 3, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | DO3942 | FL | Primary |
Addresses
Primary practice location
300 Beach Dr NE Ste 115
St Petersburg, FL 33701-3403
Mailing address
300 Beach Dr NE Ste 115
St Petersburg, FL 33701-3403
Phone (727) 800-5535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO3942 | FL | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661904000000",
"number": "1316396070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 BEACH DR NE STE 115",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337013403",
"telephone_number": "727-800-5535",
"fax_number": "727-350-3928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 BEACH DR NE STE 115",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337013403",
"telephone_number": "727-800-5535",
"fax_number": "727-350-3928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTA",
"first_name": "NEIL",
"middle_name": "S",
"credential": "L.D.O",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-03",
"last_updated": "2022-08-31",
"certification_date": "2022-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "DO3942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.