NPIMap

Individual provider Active NPI

John D Matz

  • Diagnostic Radiology Physician
  • Lake Worth, FL
National Provider Identifier
1720207814
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME14595 Issued in FL
Practice address
2290 10TH Ave N
Suite 101
Lake Worth, FL 33461-6607
Phone
(561) 540-8100
Fax
(561) 540-8489
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME14595 FL Primary

Addresses

Primary practice location

2290 10TH Ave N
Suite 101
Lake Worth, FL 33461-6607

Mailing address

2290 10TH Ave N
Suite 101
Lake Worth, FL 33461-6607
Phone (561) 540-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gardens Radiology Associates, PA Diagnostic Radiology Past Accepting new patients
Palm Beach Efl Imaging Center LLC Diagnostic Radiology Past Accepting new patients

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720207814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 10TH AVE N",
            "address_2": "SUITE 101",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616607",
            "telephone_number": "561-540-8100",
            "fax_number": "561-540-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 10TH AVE N",
            "address_2": "SUITE 101",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616607",
            "telephone_number": "561-540-8100",
            "fax_number": "561-540-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZ",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME14595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.