Individual provider Active NPI

Matthew R Wilding, AA-C

  • Anesthesiologist Assistant
  • Lithia, FL
National Provider Identifier
1487938049
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA107 Issued in FL
Practice address
6116 Avocetridge Dr
Lithia, FL 33547-4845
Phone
(201) 240-8448
NPI assigned
Sep 30, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA107 FL Primary

Addresses

Primary practice location

6116 Avocetridge Dr
Lithia, FL 33547-4845

Mailing address

6116 Avocetridge Dr
Lithia, FL 33547-4845
Phone (201) 240-8448

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120124000923 FL Practitioner - Anesthesiology Assistant 3375710866 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coral Anesthesia Associates, IncGroup PAC ID 5193986131, 47 clinicians

Practice addresses (Care Compare)

5731 Bee Ridge Rd
Sarasota, FL 34233-5056
Phone (954) 939-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA107FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwood Anesthesia Associates LLC Current Accepting new patients
Northwood Anesthesia Associates LLC CurrentSince Oct 1, 2021 Accepting new patients
Sheridan Healthcorp, Inc CurrentSince Mar 1, 2020 Accepting new patients
US Anesthesia Partners of Florida Inc. Anesthesiologist Assistant CurrentSince Oct 1, 2024 Accepting new patients
Sheridan Healthcorp Inc Current Accepting new patients
Northwood Anesthesia Associates LLC CurrentSince Oct 1, 2021 Accepting new patients
Coral Anesthesia Associates Inc CurrentSince Oct 1, 2024 Accepting new patients
Tmhpo Orthopedics Department Past Accepting new patients
Associates of Anesthesiology, LLC Past Accepting new patients

Locations

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

3291 N McMullen Booth Rd
Clearwater, FL 33761
Phone (727) 725-5800

3650 NW 82nd Ave
Ste 101
Doral, FL 33166
Phone (305) 341-7280

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

3333 Cattlemen Rd
Ste 100
Sarasota, FL 34232
Phone (941) 376-4546

5731 Bee Ridge Rd
Sarasota, FL 34233
Phone (888) 221-2216

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

1350 E Venice Ave
Venice, FL 34285
Phone (941) 445-5054

Organizations & group practices 10

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": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1487938049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116 AVOCETRIDGE DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474845",
            "telephone_number": "201-240-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6116 AVOCETRIDGE DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474845",
            "telephone_number": "201-240-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDING",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "credential": "AA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-30",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.