Organization Active NPI

Matrix Pulmonary, P.a.

  • Pulmonary Disease Physician
  • Bradenton, FL
National Provider Identifier
1982890158
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
MATRIX PULMONARY, P.A.
Practice address
2401 Manatee Ave W
Bradenton, FL 34205-4933
Phone
(941) 744-1336
Fax
(941) 746-3846
NPI assigned
Sep 20, 2007
Last updated
Feb 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Authorized official

Name
Mrs. Amy L Lewis, RN
Title
Office Manager
Phone
(941) 744-1336

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X OS7555 FL
Pulmonary Disease Physician 207RP1001X NU Primary

Addresses

Primary practice location

2401 Manatee Ave W
Bradenton, FL 34205-4933

Mailing address

2401 Manatee Ave W
Bradenton, FL 34205-4933
Phone (941) 744-1336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050413001223 FL Part B Supplier - Clinic/Group Practice 6608813365 Receives reassigned benefits from 4 practitioners
Practice locations: Bradenton, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2154487Matrix Pulmonary PA2401 Manatee Ave W, Bradenton, FL 34205Certificate of waiverSep 12, 2026

National Provider Directory

National Provider Directory

Locations

2401 Manatee Ave W
Bradenton, FL 34205
Phone (941) 744-1336

250 2nd St E
Ste 3D
Bradenton, FL 34208
Phone (941) 744-1336

520 8th St W
Bradenton, FL 34205
Phone (941) 744-1336

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519689600000",
    "number": "1982890158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054933",
            "telephone_number": "941-744-1336",
            "fax_number": "941-746-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054933",
            "telephone_number": "941-744-1336",
            "fax_number": "941-746-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX PULMONARY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2018-02-27",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "941-744-1336",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "OS7555",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.