Matthew S Ellis MD PA

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

License

ME96520 Issued in FL

Legal business name

MATTHEW S ELLIS MD PA

Practice address

6400 W Newberry Rd
Suite 104
Gainesville, FL 32605

Phone

(352) 333-5911

Fax

(353) 333-4684

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Stewart Ellis, MD

Title

President

Phone

(352) 333-5911

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1780703561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3123",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320853123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 W NEWBERRY RD",
            "address_2": "SUITE 104",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-333-5911",
            "fax_number": "353-333-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW S ELLIS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-333-5911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "FL",
            "license": "ME96520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kareana Matos Lebron, LCSW
• Anthony Matos
• David Matsibekker, MD
• Katia Matteucci, MD
• Natasha Mattevi
• Allison M Matthews, PA-C
• Charlotte R Matthews, LCSW
• Christen Matthews
• Ryan Matthews
• Stephanie Ann Matthews, AU.D.

• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.