Individual provider Active NPI

Matthew Paul Bommarito, DO

  • Internal Medicine Physician
  • Clermont, FL
National Provider Identifier
1942902655
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS23797 Issued in FL
Practice address
1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone
(352) 536-8840
Fax
(352) 536-8841
NPI assigned
Mar 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS23797 FL Primary

Addresses

Primary practice location

1900 Don Wickham Dr
Clermont, FL 34711-1979

Mailing address

1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone (352) 536-8840

Other practice location 1

14000 Fivay Rd
Hudson, FL 34667-7103
Phone (727) 992-6230

Other identifiers 1

IdentifierTypeStateIssuer
131840300MedicaidFL

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
I20260610000856 FL Practitioner - Internal Medicine 4082185020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1335 Sligh Blvd
FL 3
Orlando, FL 32806-3901

PO Box
New York, NY 10087

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: matthew.bommarito@hca4.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1942902655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-536-8840",
            "fax_number": "352-536-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-536-8840",
            "fax_number": "352-536-8841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14000 Fivay Rd",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "FL",
            "postal_code": "346677103",
            "country_code": "US",
            "telephone_number": "727-992-6230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOMMARITO",
        "first_name": "MATTHEW",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS23797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131840300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.