Individual provider Active NPI

Enrique Matta IV, CRNA

  • Certified Registered Nurse Anesthetist
  • Orlando, FL
National Provider Identifier
1366828824
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9247836 Issued in FL
Practice address
601 E Rollins St
Orlando, FL 32803-1248
Phone
(407) 667-0444
Fax
(407) 667-4338
NPI assigned
Aug 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP9247836 FL Primary

Addresses

Primary practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

291 Southhall LN
Maitland, FL 32751-7274
Phone (407) 667-0444

Other identifiers 2

IdentifierTypeStateIssuer
PENDINGOtherFLBCBS
PENDINGMedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY, MA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20150930002304 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092023648 Reassigns benefits to 5 organizations
I20181008002203 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092023648 Reassigns benefits to 6 organizations
I20191126001610 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092023648 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newark Wayne Community HospitalGroup PAC ID 0446154199, 129 clinicians
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians
The Unity Hospital of RochesterGroup PAC ID 9436060969, 732 clinicians
Clifton Springs Sanitarium CoGroup PAC ID 5092704809, 230 clinicians

Practice addresses (Care Compare)

1200 Driving Park Ave
Newark, NY 14513-1057
Phone (315) 332-2266

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4000

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 723-4000

2 Coulter Rd
Clifton Springs, NY 14432-1122
Phone (315) 462-5711

Hospital & facility affiliations

  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
ARNP9247836FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester Current Accepting new patients
Rochester General Hospital CurrentSince Feb 27, 2025 Accepting new patients
Clifton Springs Sanitarium Co CurrentSince Feb 27, 2025 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Nov 14, 2019 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 29, 2023 Accepting new patients
Canton-Potsdam Hospital Current Accepting new patients
Lawrence Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince May 31, 2023 Accepting new patients
Newark Wayne Community Hospital Current Accepting new patients
Brevard Physician Associates, PLLC CurrentSince Jul 18, 2022 Accepting new patients
United Memorial Medical Center CurrentSince Feb 27, 2025 Accepting new patients
Newark Wayne Community Hospital CurrentSince Feb 27, 2025 Accepting new patients
Canton-Potsdam Hospital CurrentSince Sep 10, 2018 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Current Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Aug 7, 2015 Accepting new patients
Brevard Physician Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 18, 2022 Accepting new patients
The Unity Hospital of Rochester CurrentSince Feb 27, 2025 Accepting new patients
Canton-Potsdam Hospital CurrentSince Sep 10, 2018 Accepting new patients
United Memorial Medical Center CurrentSince Feb 27, 2025 Accepting new patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 20, 2024 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Nov 14, 2019 Accepting new patients
Rochester General Hospital CurrentSince Feb 27, 2025 Accepting new patients
American Anesthesiology Services of Florida, Inc. CurrentSince May 13, 2022 Accepting new patients
Rochester General Hospital Current Accepting new patients
Innovative Medical Staffing Solutions Inc Nurse Anesthetist, Certified Registered CurrentSince May 25, 2023 Accepting new patients
Waterman Anesthesiology Group PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations (25 of 32)

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

430 Morton Plant St
Ste 210
Clearwater, FL 33756
Phone (727) 443-0611

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

4571 Colonial Blvd
Ste 200
Fort Myers, FL 33966
Phone (239) 333-2050

63 Barkley Cir
Ste 103
Fort Myers, FL 33907
Phone (239) 275-8882

905 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 256-0933

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

110 N Lecanto Hwy
Lecanto, FL 34461
Phone (352) 527-1825

291 Southhall Ln
Maitland, FL 32751
Phone (407) 645-1682

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

9035 Sunset Dr
Ste 200
Miami, FL 33173
Phone (786) 615-6210

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

100 N Dean Rd
Ste 102
Orlando, FL 32825
Phone (407) 506-0006

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

100 S Orange Ave
Ste 800
Orlando, FL 32801
Phone (407) 377-0251

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

483 N Semoran Blvd
Winter Park, FL 32792
Phone (407) 367-0742

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

25 Highland Ave
Newburyport, MA 01950
Phone (978) 258-4734

125 Parker Hill Ave
Roxbury Xing, MA 02120
Phone (617) 264-1100

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

16 Bank St
Batavia, NY 14020
Phone (585) 344-4800

127 North St
Batavia, NY 14020
Phone (585) 267-7510

Organizations & group practices 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1366828824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 SOUTHHALL LN",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517274",
            "telephone_number": "407-667-0444",
            "fax_number": "407-667-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-667-0444",
            "fax_number": "407-667-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTA",
        "first_name": "ENRIQUE",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-07",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9247836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "PENDING",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.