Individual provider Active NPI

Matthew Rensberry, MD

  • Family Medicine Physician
  • Winter Park, FL
National Provider Identifier
1407054851
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME117525 Issued in FL
Practice address
1850 Lee Rd Ste 134
Winter Park, FL 32789-2104
Phone
(407) 634-1690
Fax
(407) 369-4236
NPI assigned
Jul 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME117525 FL Primary
Family Medicine Physician 207Q00000X 01066107A IN
Obesity Medicine (Family Medicine) Physician 207QB0002X ME117525 FL

Addresses

Primary practice location

1850 Lee Rd Ste 134
Winter Park, FL 32789-2104

Mailing address

1850 Lee Rd Ste 134
Winter Park, FL 32789-2104
Phone (407) 634-1690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 1, 2018 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01066107AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anchor Direct Primary Care, LLC CurrentSince Jan 12, 2025 Accepting new patients

Locations

2909 N Orange Ave
Ste 101
Orlando, FL 32804
Phone (407) 228-4600

1850 Lee Rd
Ste 134
Winter Park, FL 32789
Phone (407) 389-4357

Organizations & group practices 1

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": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1407054851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 LEE RD STE 134",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892104",
            "telephone_number": "407-634-1690",
            "fax_number": "407-369-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 LEE RD STE 134",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892104",
            "telephone_number": "407-634-1690",
            "fax_number": "407-369-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENSBERRY",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME117525",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01066107A",
            "primary": false
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "FL",
            "license": "ME117525",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.