Individual provider Active NPI

Matthew Mobily, M.D.

  • Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1750669024
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME143987 Issued in FL
Practice address
653 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-3941
Fax
(904) 244-3020
NPI assigned
Aug 3, 2011
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 24557 AZ
Surgery Physician 208600000X 13199A WY
Surgery Physician 208600000X ME143987 FL Primary

Addresses

Primary practice location

653 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

PO Box 44008
Jacksonville, FL 32231-4008
Phone (904) 244-3941

Other practice location 1

5201 Yellowstone Rd
Cheyenne, WY 82009-4741
Phone (307) 632-1114

Other practice location 2

4236 N Rio Cancion Apt 142
Tucson, AZ 85718-7149
Phone (319) 541-2929

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmobily43640@direct.crmcwy.org Direct Memorial Hospital of Laramie County
Direct Messaging Address mmobily43640@direct.crmcwy.org Health Information Exchange (HIE) Memorial Hospital of Laramie County

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
I20241213001263 FL Practitioner - General Surgery 7012262108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Iowa, RJ & L Carver College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15255 Max Leggett Pkwy
Jacksonville, FL 32218-7213
Phone (904) 383-1000

5191 1St Coast Tech Pkwy
Jacksonville, FL 32224-0609
Phone (904) 427-6991

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1680

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (940) 244-4218

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Mastectomy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24557AZMDFamily Medicine Physician
13199AWYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Family Medicine Current Accepting new patients
University of Florida Jacksonville Physicians Inc Surgery CurrentSince Dec 6, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Dec 6, 2024 Accepting new patients
Cheyenne Regional Physicians Group, LLC PastSince Dec 12, 2021 Accepting new patients

Locations

653 W 8th St
Jacksonville, FL 32209
Phone (904) 244-3902

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

Interoperability endpoints

  • Direct secure messaging: mmobily43640@direct.crmcwy.org
  • Direct secure messaging: mmobily640020@direct.shands.ufl.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1750669024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3941",
            "fax_number": "904-244-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-3941",
            "fax_number": "904-244-3020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5201 Yellowstone Rd",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820094741",
            "country_code": "US",
            "telephone_number": "307-632-1114",
            "fax_number": "307-632-9920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4236 N Rio Cancion Apt 142",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857187149",
            "country_code": "US",
            "telephone_number": "319-541-2929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOBILY",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-03",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "24557",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WY",
            "license": "13199A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME143987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmobily43640@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmobily43640@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.