Individual provider Active NPI

Matthew Alexander Heckroth, MD

  • Gastroenterology Physician
  • St Augustine, FL
National Provider Identifier
1780145219
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME161079 Issued in FL
Practice address
475 W Town PL Ste 109
St Augustine, FL 32092-3648
Phone
(904) 398-7205
NPI assigned
Mar 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME161079 FL
Gastroenterology Physician 207RG0100X ME161079 FL Primary

Addresses

Primary practice location

475 W Town PL Ste 109
St Augustine, FL 32092-3648

Mailing address

4800 Belfort Rd
Jacksonville, FL 32256-6004
Phone (904) 398-7205

Other practice location 1

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (813) 745-4673

Other identifiers 2

IdentifierTypeStateIssuer
122143800MedicaidFL
7100691880MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220719003281 KY Practitioner - Internal Medicine 3476964719 Reassigns benefits to 3 organizations
I20240503001213 FL Practitioner - Internal MedicinePractitioner - Hospitalist 3476964719 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Hospitalist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778

1324 Lakeland Hill Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1100

Hospital & facility affiliations

  • Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157
  • H Lee Moffitt Cancer Center & Research Institute I Hospital, Tampa, FL, CCN 100271

Merit-based Incentive Payment System (MIPS)

Final score
88 of 100Reported as group
Quality
74.04
Promoting interoperability
100
Improvement activities
40
Cost
70.96

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
64.08
Promoting interoperability
98
Improvement activities
40
Cost
76.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME161079FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Jun 30, 2022 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Sep 21, 2022 Accepting new patients
Baptist Health Medical Group Inc Internal Medicine CurrentSince Sep 21, 2022 Accepting new patients
University of Louisville Physicians, Inc. Internal Medicine Current Accepting new patients
University of Louisville Phyisicians, Inc. CurrentSince Jun 30, 2022 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. Internal Medicine CurrentSince Oct 1, 2022 Accepting new patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc CurrentSince Jun 24, 2024 Accepting new patients
Lakeland Regional Health Systems, Inc. CurrentSince May 8, 2024 Accepting new patients
Community Medical Associates, Inc. Internal Medicine CurrentSince Oct 1, 2022 Accepting new patients
Borland Groover Clinic, PA Gastroenterology PastSince Sep 1, 2026 Accepting new patients

Locations

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720

7752 Solution Ctr
Chicago, IL 60677

1025 New Moody Ln
Lagrange, KY 40031
Phone (502) 222-3335

200 E Chestnut St
Ste 303
Louisville, KY 40202
Phone (502) 629-5552

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

550 S Jackson St
Fl 3
Louisville, KY 40202
Phone (502) 561-8850

401 E Chestnut St
Unit 310
Louisville, KY 40202
Phone (502) 584-8563

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: matthew.heckroth@direct.moffitt.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 11

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 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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1780145219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004",
            "telephone_number": "904-398-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 W TOWN PL STE 109",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923648",
            "telephone_number": "904-398-7205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12902 Usf Magnolia Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336129416",
            "country_code": "US",
            "telephone_number": "813-745-4673",
            "fax_number": "813-449-8999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HECKROTH",
        "first_name": "MATTHEW",
        "middle_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME161079",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME161079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122143800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100691880",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.