Individual provider Active NPI

Fadi A Matar, M.D.

  • Interventional Cardiology Physician
  • Tampa, FL
National Provider Identifier
1679512479
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME65062 Issued in FL
Practice address
509 S Armenia Ave
Ste 200
Tampa, FL 33609-3395
Phone
(813) 353-1515
Fax
(813) 353-0865
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X ME65062 FL Primary

Addresses

Primary practice location

509 S Armenia Ave
Ste 200
Tampa, FL 33609-3395

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other identifiers 2

IdentifierTypeStateIssuer
25143OtherFLBLUE CROSS BLUE SHIELD
375051500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fmatar8188@direct.tgh.org

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101230000175 FL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 4688707839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
University of Maryland School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12901 Bruce B Downs Blvd
Tampa, FL 33612-4742
Phone (813) 821-8038

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting24
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc CurrentSince Jan 1, 2014 Accepting new patients
University Medical Service Association Inc CurrentSince Jan 1, 2014 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
Tampa General Hospital Current Accepting new patients
Florida Cardiovascular Institute PA Past Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

137 S Pebble Beach Blvd
Ste 101
Sun City Center, FL 33573
Phone (813) 634-8000

509 S Armenia Ave
Ste 200
Tampa, FL 33609
Phone (813) 353-0248

2 Tampa General Cir
Fl 2
Tampa, FL 33606
Phone (813) 209-8596

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: fmatar8188@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1679512479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 S ARMENIA AVE",
            "address_2": "STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093395",
            "telephone_number": "813-353-1515",
            "fax_number": "813-353-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAR",
        "first_name": "FADI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME65062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "25143",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375051500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fmatar8188@direct.tgh.org",
            "affiliation": "N",
            "address_1": "509 S Armenia Ave",
            "address_2": "Ste 200",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336093395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.