Individual provider Active NPI

Matheus Silva Liebig, PA

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1386528644
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9120592 Issued in FL
Practice address
707 E Colonial Dr
Orlando, FL 32803-4600
Phone
(407) 204-7000
NPI assigned
Jul 31, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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 PA9120592 FL Primary

Addresses

Primary practice location

707 E Colonial Dr
Orlando, FL 32803-4600

Mailing address

6255 W Sunset Blvd FL 21
Los Angeles, CA 90028-7422
Phone (323) 860-5200

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
I20260129003009 FL Practitioner - Physician Assistant 1254819485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4131 NW 20TH Dr
Gainesville, FL 32605-1824

8390 Champions Gate Blvd
Suite 220
Champions Gate, FL 33896-8310

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9120592FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
AIDS Healthcare Foundation CurrentSince Oct 18, 2025 Accepting new patients
AIDS Healthcare Foundation CurrentSince Oct 18, 2025 Accepting new patients

Locations

6255 W Sunset Blvd
Fl 21
Los Angeles, CA 90028
Phone (323) 860-5200

707 E Colonial Dr
Orlando, FL 32803
Phone (407) 204-7000

1701 N Mills Ave
Orlando, FL 32803
Phone (407) 204-7000

3135 State Road 580
Ste 1
Safety Harbor, FL 34695
Phone (727) 259-2000

Interoperability endpoints

  • Direct secure messaging: matheus.liebig.1@26356.direct.athenahealth.com

Organizations & group practices 3

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": "1753920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1386528644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 W SUNSET BLVD FL 21",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287422",
            "telephone_number": "323-860-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034600",
            "telephone_number": "407-204-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVA LIEBIG",
        "first_name": "MATHEUS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-31",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9120592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.