Individual provider Active NPI

Matilda Said

  • Physician Assistant
  • Port Saint Lucie, FL
National Provider Identifier
1508663113
Registry record updated Mar 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9119876 Issued in FL
Practice address
612 SW Prado Ave
Port Saint Lucie, FL 34983-1846
Phone
(772) 267-3006
NPI assigned
Mar 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9119876 FL Primary

Addresses

Primary practice location

612 SW Prado Ave
Port Saint Lucie, FL 34983-1846

Mailing address

612 SW Prado Ave
Port Saint Lucie, FL 34983-1846
Phone (772) 267-3006

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
I20250603004423 FL Practitioner - Physician Assistant 2466961131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Absolute Health Internal Medicine and PediatricsGroup PAC ID 6406856103, 12 clinicians
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

7350 SW 60TH Ave
Suite 2
Ocala, FL 34476-6476
Phone (352) 854-5530

8449 SW Hwy 200
Suite 141
Ocala, FL 34481-9695
Phone (352) 693-3378

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9119876FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Health Internal Medicine & Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCECAA

Organizations & group practices 2

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": "1740787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740787200000",
    "number": "1508663113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 SW PRADO AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831846",
            "telephone_number": "772-267-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 SW PRADO AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831846",
            "telephone_number": "772-267-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAID",
        "first_name": "MATILDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-01",
        "last_updated": "2025-03-01",
        "certification_date": "2025-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9119876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.