Individual provider Active NPI

Matthew Walker, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1942824032
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113354 Issued in FL
Practice address
2501 N Orange Ave Ste 514
Orlando, FL 32804-4674
Phone
(407) 303-5687
Fax
(407) 303-0806
NPI assigned
Jun 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 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 PA9113354 FL Primary

Addresses

Primary practice location

2501 N Orange Ave Ste 514
Orlando, FL 32804-4674

Mailing address

2501 N Orange Ave Ste 514
Orlando, FL 32804-4674
Phone (407) 303-5687

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
I20201201000661 FL Practitioner - Physician Assistant 5092126813 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9113354FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Jul 6, 2021 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jul 6, 2021 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2501 N Orange Ave
Ste 340
Orlando, FL 32804
Phone (407) 872-7822

2501 N Orange Ave
Orlando, FL 32804
Phone (407) 303-2024

2501 N Orange Ave
Ste 514
Orlando, FL 32804
Phone (407) 303-2474

Interoperability endpoints

  • Direct secure messaging: mwalker73915@adventhealth.direct-ci.com

Organizations & group practices 2

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": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1942824032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 514",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044674",
            "telephone_number": "407-303-5687",
            "fax_number": "407-303-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 514",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044674",
            "telephone_number": "407-303-5687",
            "fax_number": "407-303-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.