Individual provider Active NPI

Matthew Thomas, MD

  • Emergency Medicine Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1699744177
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME0076345 Issued in FL
Practice address
3555 Northlake Blvd Ste 2
Palm Beach Gardens, FL 33403-1650
Phone
(561) 626-4878
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME0076345 FL Primary

Addresses

Primary practice location

3555 Northlake Blvd Ste 2
Palm Beach Gardens, FL 33403-1650

Mailing address

3555 Northlake Blvd Ste 2
Palm Beach Gardens, FL 33403-1650
Phone (561) 626-4878

Other identifiers 1

IdentifierTypeStateIssuer
47100OtherFLBCBS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040207000035 FL Practitioner - Emergency Medicine 7618860016 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0076345FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Em Alliance LLC Emergency Medicine CurrentSince Nov 7, 2023 Accepting new patients
Blue Radiology Services LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

1155 S Congress Ave
Ste C
West Palm Beach, FL 33406
Phone 5617661300601

16750 Persimmon Blvd
Westlake, FL 33470
Phone (561) 791-7200

7 Easton Oval
#L4387
Columbus, OH 43219

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1699744177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 NORTHLAKE BLVD STE 2",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334031650",
            "telephone_number": "561-626-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 NORTHLAKE BLVD STE 2",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334031650",
            "telephone_number": "561-626-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME0076345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "47100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.