Individual provider Active NPI

Matthew Cody Messina, PA-C

  • Physician Assistant
  • Wellington, FL
National Provider Identifier
1861151961
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115188 Issued in FL
Practice address
10115 Forest Hill Blvd Ste 100
Wellington, FL 33414-6178
Phone
(561) 333-1118
NPI assigned
Dec 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9115188 FL Primary

Addresses

Primary practice location

10115 Forest Hill Blvd Ste 100
Wellington, FL 33414-6178

Mailing address

10115 Forest Hill Blvd
Wellington, FL 33414-3105
Phone (561) 333-1118

Other identifiers 1

IdentifierTypeStateIssuer
PA9115188OtherFLPHYSICIAN ASSISTANT

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
I20220223000733 FL Practitioner - Physician Assistant 8729472436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesiscare USA of Florida LLCGroup PAC ID 9830082882, 172 clinicians

Practice addresses (Care Compare)

10115 Forest Hill Blvd
Suite 100
Wellington, FL 33414-6178
Phone (561) 333-1118

1419 SE 8TH Ter
Cape Coral, FL 33990-3213
Phone (239) 772-3202

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genesiscare USA of Florida LLC CurrentSince Jan 3, 2022 Accepting new patients
Genesiscare USA of Florida LLC CurrentSince Jan 3, 2022 Accepting new patients
Genesiscare USA of Florida LLC Past Accepting new patients

Locations

1419 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 772-3202

3680 Broadway
Fort Myers, FL 33901
Phone (239) 936-0380

2270 Colonial Blvd
Fort Myers, FL 33907
Phone (239) 344-2391

10115 Forest Hill Blvd
Ste 100
West Palm Beach, FL 33414
Phone (561) 333-1118

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1861151961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10115 FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143105",
            "telephone_number": "561-333-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10115 FOREST HILL BLVD STE 100",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146178",
            "telephone_number": "561-333-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSINA",
        "first_name": "MATTHEW",
        "middle_name": "CODY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "PA9115188",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.