Individual provider Active NPI

Mathew Jelani Marin Pagan, CRNA

  • Certified Registered Nurse Anesthetist
  • Largo, FL
National Provider Identifier
1427739879
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11041160 Issued in FL
Practice address
201 14TH St SW
Largo, FL 33770-3133
Phone
(727) 588-5200
NPI assigned
Jul 28, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 98365-G PR
Registered Nurse 163W00000X 26NR19557300 NJ
Certified Registered Nurse Anesthetist 367500000X 11041160 FL Primary

Addresses

Primary practice location

201 14TH St SW
Largo, FL 33770-3133

Mailing address

114 Hampton Rd Apt 102
Clearwater, FL 33759-4110
Phone (787) 403-5415

Other practice location 1

Escuela de Enfermeria - RCM
P. Dr. Jose Celso Barbosa
San Juan, PR 00921
Phone (787) 758-2525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251029002749 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113416223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunshine State Anesthesia Partners LLCGroup PAC ID 8123434792, 429 clinicians

Practice addresses (Care Compare)

201 14TH St SW
Largo, FL 33770-3133
Phone (727) 588-5200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NR19557300NJMDRegistered Nurse
98365-GPRMDRegistered Nurse
11041160FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine State Anesthesia Partners LLC CurrentSince Oct 6, 2025 Accepting new patients

Locations

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

201 14th St SW
Largo, FL 33770
Phone (727) 588-5222

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1427739879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HAMPTON RD APT 102",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594110",
            "telephone_number": "787-403-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 14TH ST SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703133",
            "telephone_number": "727-588-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Escuela de Enfermeria - RCM",
            "address_2": "P. Dr. Jose Celso Barbosa",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "00921",
            "country_code": "US",
            "telephone_number": "787-758-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARIN PAGAN",
        "first_name": "MATHEW",
        "middle_name": "JELANI",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-28",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PR",
            "license": "98365-G",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR19557300",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11041160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.