Individual provider Active NPI

Matthew Simmons, P.A.

  • Medical Physician Assistant
  • Panama City, FL
National Provider Identifier
1326165572
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9104878 Issued in FL
Practice address
204 E 19TH St
Panama City, FL 32405-4707
Phone
(850) 763-5409
Fax
(850) 763-7129
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9104878 FL Primary

Addresses

Primary practice location

204 E 19TH St
Panama City, FL 32405-4707

Mailing address

204 E 19TH St
Panama City, FL 32405-4707
Phone (850) 763-5409

Other identifiers 2

IdentifierTypeStateIssuer
PA9104878OtherFLFL MEDICAL LICENSE
001855OtherCTSTATE PA LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140124000009 FL Practitioner - Physician Assistant 7618105438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Digestive Diseases Center of Florida PLLCGroup PAC ID 0345227328, 15 clinicians

Practice addresses (Care Compare)

204 E 19TH St
Panama City, FL 32405-4707
Phone (850) 763-5409

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Promoting interoperability
90
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9104878FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Diseases Center of Florida, PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: matthew.simmons.p1@direct.ddc.nextgenshare.com

Organizations & group practices 2

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1326165572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E 19TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054707",
            "telephone_number": "850-763-5409",
            "fax_number": "850-763-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E 19TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054707",
            "telephone_number": "850-763-5409",
            "fax_number": "850-763-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICAL LICENSE",
            "identifier": "PA9104878",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PA LICENSE",
            "identifier": "001855",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.