Individual provider Active NPI

Matthew Edward Hardy, M.D.

  • Surgery Physician
  • Hollywood, FL
National Provider Identifier
1457647778
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME122404 Issued in FL
Practice address
3800 S Ocean Dr Ste 209
Hollywood, FL 33019
Phone
(305) 466-9988
Fax
(305) 466-9989
NPI assigned
Jun 24, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME122404 FL Primary

Addresses

Primary practice location

3800 S Ocean Dr Ste 209
Hollywood, FL 33019

Mailing address

3800 S Ocean Dr Ste 209
Hollywood, FL 33019-2915
Phone (305) 466-9988

Other practice location 1

289 S Culver St
Lawrenceville, GA 30046-4805
Phone (305) 466-9988

Other practice location 2

3800 S Ocean Dr Ste 209
Hollywood, FL 33019
Phone (305) 466-9988

Other practice location 3

160 Mine Lake Ct Ste 200
Raleigh, NC 27615-6417
Phone (305) 466-9988

Other identifiers 2

IdentifierTypeStateIssuer
077830OtherGASTATE LICENSE
2018-00443OtherNCNC STATE LICENSE

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1457647778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 S OCEAN DR STE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192915",
            "telephone_number": "305-466-9988",
            "fax_number": "305-466-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S OCEAN DR STE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33019",
            "telephone_number": "305-466-9988",
            "fax_number": "305-466-9989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "289 S Culver St",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300464805",
            "country_code": "US",
            "telephone_number": "305-466-9988",
            "fax_number": "305-466-9989",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 S Ocean Dr Ste 209",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "33019",
            "country_code": "US",
            "telephone_number": "305-466-9988",
            "fax_number": "305-466-9989",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 Mine Lake Ct Ste 200",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276156417",
            "country_code": "US",
            "telephone_number": "305-466-9988",
            "fax_number": "305-466-9989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDY",
        "first_name": "MATTHEW",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-24",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME122404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "077830",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE LICENSE",
            "identifier": "2018-00443",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.