Individual provider Active NPI

Merna Karen Matilsky, M.D.

  • Family Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1881614113
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0076956 Issued in FL
Practice address
2900 N Military TRL # 245
Suite 245
Boca Raton, FL 33431-6365
Phone
(561) 994-2007
Fax
(561) 994-2003
NPI assigned
Jul 20, 2006
Last updated
Feb 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0076956 FL Primary

Addresses

Primary practice location

2900 N Military TRL # 245
Suite 245
Boca Raton, FL 33431-6365

Mailing address

2900 N Military TRL # 245
Suite 245
Boca Raton, FL 33431-6365
Phone (561) 994-2007

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040830000226 FL Practitioner - Family Practice 3173598521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Pennsylvania, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2900 N Military Trail
Suite 245
Boca Raton, FL 33431-6362
Phone (561) 994-2007

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0076956FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Merna Matilsky MD PA Family Medicine CurrentSince Sep 1, 2005 Accepting new patients

Locations

2900 N Military Trl
Ste 245
Boca Raton, FL 33431
Phone (561) 994-2007

7300 Del Prado Cir S
Boca Raton, FL 33433
Phone (561) 392-3000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1881614113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N MILITARY TRL # 245",
            "address_2": "SUITE 245",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316365",
            "telephone_number": "561-994-2007",
            "fax_number": "561-994-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N MILITARY TRL # 245",
            "address_2": "SUITE 245",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316365",
            "telephone_number": "561-994-2007",
            "fax_number": "561-994-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATILSKY",
        "first_name": "MERNA",
        "middle_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "0076956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.