Individual provider Active NPI

Matthew Pourani, PA

  • Surgical Physician Assistant
  • Miami, FL
National Provider Identifier
1811268469
Registry record updated May 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
9102508 Issued in FL
Practice address
909 W 47TH St
Miami, FL 33140-2904
Phone
(786) 355-5966
NPI assigned
Jan 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 9102508 FL Primary

Addresses

Primary practice location

909 W 47TH St
Miami, FL 33140-2904

Mailing address

960 W 41St St Ste 214
Miami Beach, FL 33140-3349
Phone (305) 482-1415

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160126000428 FL Practitioner - Physician Assistant 9436452414 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9102508FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Diamond Med Spa CurrentSince May 18, 2025 Accepting new patients
Indian River Health Services Inc CurrentSince Mar 24, 2025 Accepting new patients
Indian River Health Services Inc CurrentSince Mar 24, 2025 Accepting new patients

Locations

960 W 41st St
Ste 214
Miami Beach, FL 33140
Phone (305) 482-1415

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746921600000",
    "number": "1811268469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 W 41ST ST STE 214",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403349",
            "telephone_number": "305-482-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 W 47TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331402904",
            "telephone_number": "786-355-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURANI",
        "first_name": "MATTHEW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-13",
        "last_updated": "2025-05-11",
        "certification_date": "2025-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9102508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.