Active NPI
Matthew David Garber, MD
- Pediatrics Physician
- Jacksonville, FL
National Provider Identifier
1396789889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME128099
- Practice address
- 800 Prudential Dr
Jacksonville, FL 32207-8202 - Phone
- (904) 202-8758
- Fax
- (904) 202-8758
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 17997 | SC | |
| Hospitalist Physician | 208M00000X | ME128099 | FL | |
| Pediatrics Physician | 208000000X | ME128099 | FL | Primary |
Addresses
Primary practice location
800 Prudential Dr
Jacksonville, FL 32207-8202
Mailing address
PO Box 44008
Jacksonville, FL 32231-4008
Phone (904) 244-3312
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 57-6007863103 | Other | SC | BLUE CHOICE OF SC |
| '020104400 | Medicaid | FL | |
| 5162631 | Other | SC | AETNA |
| 179979 | Medicaid | SC | |
| 57-6007863032 | Other | SC | BCBS OF SC |
| 7384439 | Other | SC | CIGNA |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME128099 | FL | MD | Pediatrics Physician |
| 17997 | SC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Nemours Foundation | Current | Accepting new patients | |
| University of Florida Jacksonville Physicians, Inc. | Current | Accepting new patients | |
| The Nemours Foundation | Current | Accepting new patients | |
| The Nemours Foundation | Current | Accepting new patients | |
| University of Florida Jacksonville Physicians, Inc. | Pediatrics | Current | Accepting new patients |
| Greenville Proaxis Therapy, LLC | Past | Accepting new patients | |
| Greenville Health System | Past | Accepting new patients |
Locations
1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110
800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000
807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600
Interoperability endpoints
- mgarber216499@direct.shands.ufl.edu
Organizations & group practices 7
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.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1386658615
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1144276452
Pediatrics
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1265585806
-
- Physiological Laboratory
- Jacksonville, FL
- NPI 1831800952
-
- Children's Hospital
- Wilmington, DE
- NPI 1467505073
-
- General Acute Care Hospital
- Simpsonville, SC
- NPI 1679992838
-
- Physical Therapist
- Greenville, SC
- NPI 1669457859
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646179200000",
"number": "1396789889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 44008",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322314008",
"telephone_number": "904-244-3312",
"fax_number": "904-244-3425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 PRUDENTIAL DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078202",
"telephone_number": "904-202-8758",
"fax_number": "904-202-8758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARBER",
"first_name": "MATTHEW",
"middle_name": "DAVID",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2022-03-02",
"certification_date": "2022-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "17997",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "FL",
"license": "ME128099",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME128099",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE OF SC",
"identifier": "57-6007863103",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "'020104400",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5162631",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "179979",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF SC",
"identifier": "57-6007863032",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "7384439",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.