Active NPI
Matthew Severin, MD
- Student in an Organized Health Care Education/Training Program
- Winter Park, FL
National Provider Identifier
1922788322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- TRN37954
- Practice address
- 133 Benmore Dr Ste 201
Winter Park, FL 32792-4111 - Phone
- (407) 646-7757
- Fax
- (407) 303-7757
- NPI assigned
- Jul 20, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | TRN37954 | FL | Primary |
| Family Medicine Physician | 207Q00000X | 2026-03878 | NC |
Addresses
Primary practice location
133 Benmore Dr Ste 201
Winter Park, FL 32792-4111
Mailing address
133 Benmore Dr Ste 201
Winter Park, FL 32792-4111
Phone (407) 646-7757
Other practice location 1
1942 E 7th St Ste 200
Charlotte, NC 28204-2557
Phone (704) 384-7085
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230804003242 | FL | Order and Referring Only - Family Practice | 0042671117 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRN37954 | FL | MD | Student in an Organized Health Care Education/Training Program |
Interoperability endpoints
- mseverin1723526@adventhealth.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1922788322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 BENMORE DR STE 201",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327924111",
"telephone_number": "407-646-7757",
"fax_number": "407-303-7323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 BENMORE DR STE 201",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327924111",
"telephone_number": "407-646-7757",
"fax_number": "407-303-7757"
}
],
"practiceLocations": [
{
"address_1": "1942 E 7th St Ste 200",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282042557",
"country_code": "US",
"telephone_number": "704-384-7085",
"fax_number": "704-384-7089",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SEVERIN",
"first_name": "MATTHEW",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-20",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "TRN37954",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2026-03878",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.