NPIMap

Individual provider Active NPI

Matthew James Deeter, MD

  • Surgery Physician
  • Miami, FL
National Provider Identifier
1841400587
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
28407 Issued in AZ
Practice address
11760 Bird Rd
Suite 722
Miami, FL 33175-3582
Phone
(305) 559-1883
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 28407 AZ Primary

Addresses

Primary practice location

11760 Bird Rd
Suite 722
Miami, FL 33175-3582

Mailing address

11760 Bird Road
Suite 722
Miami, FL 33175-3582
Phone (305) 559-1883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070827000570 WA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 8628160249 Reassigns benefits to 1 organization
I20170915001330 NV Practitioner - General Surgery 8628160249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York Medical College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Practice addresses (Care Compare)

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28407AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Community Care Services LLC CurrentSince Mar 21, 2018 Accepting new patients
Community Care Services LLC CurrentSince Mar 21, 2018 Accepting new patients
Gomez Kozar McElreath Smith Surgery CurrentSince Nov 18, 2021 Accepting new patients
Multicare Health System CurrentSince Nov 27, 2016 Accepting new patients
Multicare Health System CurrentSince Nov 27, 2016 Accepting new patients
Thoracic & Cardiovascular Surgeons LLC Past Accepting new patients
Lawnwood Healthcare Specialists LLC Past Accepting new patients
Renown Regional Medical Center Past Accepting new patients

Locations

75 Pringle Way
Ste 1002
Reno, NV 89502
Phone (702) 323-7500

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

6554 S McCarran Blvd
Ste B
Reno, NV 89509
Phone (702) 324-0288

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Interoperability endpoints

  • Direct secure messaging: matthew.deeter@premieresurgical.directbygreenway.com
  • Direct secure messaging: mdeeter123489@direct.renown.org

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 5

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1841400587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11760 BIRD ROAD",
            "address_2": "SUITE 722",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753582",
            "telephone_number": "305-559-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11760 BIRD RD",
            "address_2": "SUITE 722",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753582",
            "telephone_number": "305-559-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEETER",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "28407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.