Individual provider Active NPI

David Matos, MOT, OTR/L

  • Occupational Therapist
  • Port St Lucie, FL
National Provider Identifier
1376067520
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT18631 Issued in FL
Practice address
8881 SW Montova Way
Port St Lucie, FL 34987-8708
Phone
(772) 521-5238
Fax
(772) 673-8444
NPI assigned
Jul 31, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT18631 FL Primary

Addresses

Primary practice location

8881 SW Montova Way
Port St Lucie, FL 34987-8708

Mailing address

8881 SW Montova Way
Port St Lucie, FL 34987-8708
Phone (772) 521-5238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT18631FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
David R Matos Occupational Therapy Services LLC Occupational Therapist CurrentSince Aug 4, 2024 Accepting new patients
Grace Therapies, LLC Occupational Therapist Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1376067520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8881 SW MONTOVA WAY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349878708",
            "telephone_number": "772-521-5238",
            "fax_number": "772-673-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8881 SW MONTOVA WAY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349878708",
            "telephone_number": "772-521-5238",
            "fax_number": "772-673-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS",
        "first_name": "DAVID",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT18631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.