Matthew John Tavolacci, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH10273 Issued in FL

Practice address

12797 Forest Hill Blvd
Suite B
Wellington, FL 33414-4763

Phone

(561) 793-5550

Fax

(561) 793-5788

NPI assigned

Mar 28, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wellington Physical Therapy Inc

  • Physical Therapist
  • Wellington, FL
  • NPI 1790842854

  Chiropractor

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1269734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1558686014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12797 FOREST HILL BLVD",
            "address_2": "SUITE B",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144763",
            "telephone_number": "561-793-5550",
            "fax_number": "561-793-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12797 FOREST HILL BLVD",
            "address_2": "SUITE B",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144763",
            "telephone_number": "561-793-5550",
            "fax_number": "561-793-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVOLACCI",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-28",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008631",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shalini Tailor
• Tampa General Provider Network Inc
• Tampa General Provider Network Inc
• Edkenny Tamparia
• Derek James Tams
• Sherry Mina Moreed Tawadros
• Jacob Taylor, PHARMD
• Jamie Taylor, APRN
• Taylors Adult Home Care Inc,
• Tboa

• Chiropractor in Wellington, FL
• Providers in Wellington, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.