Peter J Mattina, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME15265 Issued in FL

Practice address

800 39TH St W
Bradenton, FL 34205-2456

Phone

(941) 747-4664

Fax

(941) 747-3067

NPI assigned

Aug 12, 2006

Last updated

Feb 15, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1568474344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 39TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342052456",
            "telephone_number": "941-747-4664",
            "fax_number": "941-747-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 39TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342052456",
            "telephone_number": "941-747-4664",
            "fax_number": "941-747-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINA",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME15265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keerthika Mathialagan, MD
• Matrix Pulmonary, P.a.
• Karen Matta-Toomey, M.D.
• Jose R Matta, MD
• Alex Matthaeus
• Charles William Mattis, DDS
• Mary Louise Mattison, APRN
• Zachary Matunas, PHARMD
• Daniel Matute, BS
• Annetta J Matyasi, PTA

• Dermatology Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.