NPIMap

Individual provider Active NPI

Matthew David Waldron, M.D.

  • Family Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1760460729
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME125041 Issued in FL
Practice address
2217 N University Dr
Pembroke Pines, FL 33024-3611
Phone
(954) 883-8140
Fax
(954) 883-8144
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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 ME125041 FL Primary

Addresses

Primary practice location

2217 N University Dr
Pembroke Pines, FL 33024-3611

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwaldron130162@MHSDIRECT.NET Direct

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
I20151229000595 FL Practitioner - Family Practice 8820074040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Ohio, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

6730 Miramar Pkwy
Miramar, FL 33023-4838
Phone (954) 276-6600

Hospital & facility affiliations

  • Tehc LLC Home health agency, Doral, FL, CCN 107773
  • Memorial Hospital Pembroke Hospital, Pembroke Pines, FL, CCN 100230
  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038
  • Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME125041FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Jan 1, 2016 Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District CurrentSince Jan 1, 2016 Accepting new patients
Major Hospital Past Accepting new patients
South Broward Hospital District Past Accepting new patients
Marion Physician Billing LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Marion General Hospital Foundation, Inc. Past Accepting new patients
Indiana University Health Paoli Inc Past Accepting new patients

Locations

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

6730 Miramar Pkwy
Miramar, FL 33023
Phone (954) 276-6600

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

2217 N University Dr
Pembroke Pines, FL 33024
Phone (954) 883-8140

Interoperability endpoints

  • Direct secure messaging: mwaldron130162@mhsdirect.net

Organizations & group practices 9

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 6

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1760460729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "fax_number": "812-723-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243611",
            "telephone_number": "954-883-8140",
            "fax_number": "954-883-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME125041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwaldron130162@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2217 N University Dr",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330243611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.