Active NPI
Thomas Frederick Mattras, M.D.
- Internal Medicine Physician
- Fort Myers, FL
National Provider Identifier
1811150089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME68657
- Practice address
- 3033 Winkler Avenue Ext
Fort Myers, FL 33916-9413 - Phone
- (239) 939-3939
- Fax
- (239) 931-6116
- NPI assigned
- Jul 8, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME68657 | FL | Primary |
Addresses
Primary practice location
3033 Winkler Avenue Ext
Fort Myers, FL 33916-9413
Mailing address
3033 Winkler Avenue Ext
Fort Myers, FL 33916-9413
Phone (239) 939-3939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME68657 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215475200000",
"number": "1811150089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3033 WINKLER AVENUE EXT",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339169413",
"telephone_number": "239-939-3939",
"fax_number": "239-931-6116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3033 WINKLER AVENUE EXT",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339169413",
"telephone_number": "239-939-3939",
"fax_number": "239-931-6116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTRAS",
"first_name": "THOMAS",
"middle_name": "FREDERICK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-08",
"last_updated": "2008-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME68657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.