NPIMap

Individual provider Active NPI

Matthew Dorman, MD

  • Family Medicine Physician
  • Palm Coast, FL
National Provider Identifier
1740284439
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
76456 Issued in FL
Practice address
9 Pine Cone Dr
Suite 102
Palm Coast, FL 32137-8686
Phone
(386) 445-6191
Fax
(386) 445-3916
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

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
Family Medicine Physician 207Q00000X 76456 FL Primary

Addresses

Primary practice location

9 Pine Cone Dr
Suite 102
Palm Coast, FL 32137-8686

Mailing address

9 Pine Cone Dr
Suite 102
Palm Coast, FL 32137-8686
Phone (386) 445-6191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040602001138 FL Practitioner - Family PracticePractitioner - Diagnostic Radiology 0941282198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Alabama College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Palm Harbor Family Practice and Walk-in Clinic, P.aGroup PAC ID 9133108541, 7 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

9 Pine Cone Dr
Suite 102
Palm Coast, FL 32137-8683
Phone (386) 445-6191

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions36
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76456FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Harbor Family Practice and Walk in Clinic PA CurrentSince Aug 13, 2005 Accepting new patients
F R Fruehan Family Practice Inc Family Medicine Past Accepting new patients
North Okaloosa Clinic Corp Family Medicine Past Accepting new patients

Locations

9 Pine Cone Dr
Ste 102
Palm Coast, FL 32137
Phone (386) 445-6191

Organizations & group practices 3

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 9

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740284439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 PINE CONE DR",
            "address_2": "SUITE 102",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378686",
            "telephone_number": "386-445-6191",
            "fax_number": "386-445-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PINE CONE DR",
            "address_2": "SUITE 102",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378686",
            "telephone_number": "386-445-6191",
            "fax_number": "386-445-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMAN",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "76456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.