Individual provider Active NPI

John Mathew Hoffstetter, PA-C

  • Physician Assistant
  • Coral Springs, FL
National Provider Identifier
1366454951
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9106128 Issued in FL
Practice address
3000 N University Dr
Suite K
Coral Springs, FL 33065-5055
Phone
(954) 752-2630
Fax
(954) 755-1865
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9106128 FL Primary

Addresses

Primary practice location

3000 N University Dr
Suite K
Coral Springs, FL 33065-5055

Mailing address

10516 W Sample Rd
Coral Springs, FL 33065-3740
Phone (719) 538-7861

Other identifiers 1

IdentifierTypeStateIssuer
GM636ZOtherFLMEDICARE

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
I20120926000560 FL Practitioner - Physician Assistant 6002815776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin and Cancer AssociatesGroup PAC ID 1759284847, 65 clinicians

Practice addresses (Care Compare)

13660 S Jog Rd
Suite 8
Delray Beach, FL 33446-3806
Phone (561) 637-4040

3000 N University Dr
Suite K
Coral Springs, FL 33065-5082
Phone (954) 752-2630

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9106128FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rebecca S Davis-Trujillo MD PC Past Accepting new patients
James L Derickson MD PC Past Accepting new patients
Skin and Cancer Associates PastSince Jun 30, 2024 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1366454951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10516 W SAMPLE RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653740",
            "telephone_number": "719-538-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N UNIVERSITY DR",
            "address_2": "SUITE K",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655055",
            "telephone_number": "954-752-2630",
            "fax_number": "954-755-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFSTETTER",
        "first_name": "JOHN",
        "middle_name": "MATHEW",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GM636Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.