Individual provider Active NPI

Brett Mattei, PA-C

  • Surgical Physician Assistant
  • Sarasota, FL
National Provider Identifier
1467798454
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA 9106936 Issued in FL
Practice address
1921 Waldemere St
Suite 504
Sarasota, FL 34239-2943
Phone
(941) 917-8525
Fax
(941) 917-8526
NPI assigned
Dec 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA 9106936 FL Primary
Physician Assistant 363A00000X PA9106936 FL

Addresses

Primary practice location

1921 Waldemere St
Suite 504
Sarasota, FL 34239-2943

Mailing address

PO Box 863407
Orlando, FL 32886-3407
Phone (941) 917-2600

Other identifiers 1

IdentifierTypeStateIssuer
8164200MedicaidFL

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
I20130117000100 FL Practitioner - Physician Assistant 0648423905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

1700 S Tamiami Trail
FPG Central Billing Office
Sarasota, FL 34239-3509

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-7760

1921 Waldemere St
Sarasota, FL 34239-2941

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9106936FLMDPhysician Assistant
PA 9106936FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Orthopedics & Sports Medicine of Southwest Florida PA CurrentSince Jan 28, 2013 Accepting new patients
SMH Physician Services Inc Physician Assistant CurrentSince Jun 6, 2016 Accepting new patients
SMH Physician Services Inc Past Accepting new patients

Locations

8340 Lakewood Ranch Blvd
Ste 300
Lakewood Ranch, FL 34202
Phone (941) 316-8200

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1921 Waldemere St
Ste 504
Sarasota, FL 34239
Phone (941) 917-1579

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: brett.mattei@fpg.directbygreenway.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.

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": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1467798454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 WALDEMERE ST",
            "address_2": "SUITE 504",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392943",
            "telephone_number": "941-917-8525",
            "fax_number": "941-917-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTEI",
        "first_name": "BRETT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-18",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA 9106936",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106936",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8164200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.