Individual provider Active NPI

Matthew Severin, MD

  • Student in an Organized Health Care Education/Training Program
  • Winter Park, FL
National Provider Identifier
1922788322
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
TRN37954 Issued in FL
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

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230804003242 FL Order and Referring Only - Family PracticePractitioner - Family Practice 0042671117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN37954FLMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: 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

Verify at the official NPI Registry.