NPIMap

Individual provider Active NPI

Matthew Hal Thompson, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • South Daytona, FL
National Provider Identifier
1336896687
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11016871 Issued in FL
Practice address
2435 Kenilworth Ave
South Daytona, FL 32119-2753
Phone
(386) 334-0061
NPI assigned
Mar 7, 2022
Last updated
Mar 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11016871 FL Primary

Addresses

Primary practice location

2435 Kenilworth Ave
South Daytona, FL 32119-2753

Mailing address

2435 Kenilworth Ave
South Daytona, FL 32119-2753
Phone (386) 334-0061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220418000818 FL Practitioner - Nurse Practitioner 2264829464 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.01 of 100Reported as group
Quality
72.99
Promoting interoperability
82
Improvement activities
40
Cost
78.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11016871FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Telecare, PLLC CurrentSince Jun 24, 2025 Accepting new patients
Public Health Trust of Miami Dade County Florida Current Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 3, 2024 Accepting new patients
Public Health Trust of Miami Dade County Florida Current Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 3, 2024 Accepting new patients
Forefront Telecare Inc CurrentSince Jul 1, 2023 Accepting new patients
Halifax Healthcare Systems Inc CurrentSince Apr 1, 2022 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 3, 2024 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 3, 2024 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 3, 2024 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1695 NW 9th Ave
Miami, FL 33136
Phone (305) 355-7147

15055 NW 27th Ave
Opa Locka, FL 33054
Phone (786) 466-2701

20201 NW 37th Ave
Opa Locka, FL 33056
Phone (786) 466-2700

115 N Calhoun St
Ste 4
Tallahassee, FL 32301
Phone (323) 776-3632

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1336896687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 KENILWORTH AVE",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321192753",
            "telephone_number": "386-334-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 KENILWORTH AVE",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321192753",
            "telephone_number": "386-334-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MATTHEW",
        "middle_name": "HAL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11016871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

Verify at the official NPI Registry.