Individual provider Active NPI

Matthew Hathaway, APRN, FNP-C

  • Family Nurse Practitioner
  • Safety Harbor, FL
National Provider Identifier
1508686254
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11034225 Issued in FL
Practice address
3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607
Phone
(727) 725-6111
NPI assigned
Oct 16, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11034225 FL Primary

Addresses

Primary practice location

3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607

Mailing address

3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607
Phone (727) 725-6111

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
I20251118004968 FL Practitioner - Nurse Practitioner 3375034259 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

3003 W Dr Martin Luther King Jr Blvd
Mab 2ND Floor
Tampa, FL 33607-6307
Phone (813) 872-7737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11034225FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Mar 1, 2026 Accepting new patients
Trustees of Mease Hospital, Inc CurrentSince Sep 23, 2025 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Mar 1, 2026 Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

455 Pinellas St
Ste 250
Clearwater, FL 33756
Phone (727) 298-6726

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

3003 W Mlk Blvd
Fl 2
Tampa, FL 33607
Phone (813) 321-6580

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.

NPI Registry JSON

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1508686254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 MCMULLEN BOOTH RD",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346956607",
            "telephone_number": "727-725-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 MCMULLEN BOOTH RD",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346956607",
            "telephone_number": "727-725-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "MATTHEW",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11034225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Safety Harbor, FL

Sources for this page

Verify at the official NPI Registry.