Matthew Douglas Radding, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9119276 Issued in FL

Practice address

1005 N 35TH Ave
Hollywood, FL 33021-5402

Phone

(954) 265-6301

Fax

(954) 985-1434

NPI assigned

Jan 9, 2023

Last updated

Dec 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mradding386544@mhsdirect.net

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1316651029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E HALLANDALE BEACH BLVD",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094488",
            "telephone_number": "954-454-5131",
            "fax_number": "954-241-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 N 35TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215402",
            "telephone_number": "954-265-6301",
            "fax_number": "954-985-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADDING",
        "first_name": "MATTHEW",
        "middle_name": "DOUGLAS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-09",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119276",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mradding386544@MHSDIRECT.NET",
            "affiliation": "Y",
            "affiliationName": "Joe DiMaggio Children's Hospital",
            "address_1": "1005 N 35th Ave",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.