Look up the most recent NPI and PECOS records

John Matos

Internal Medicine

Allopathic & Osteopathic Physicians

1611 NW 12th Ave # 600b, Miami, FL 33136

PECOS Enrollment

Based on the most recent information from CMS, provider John Matos is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1407942618
Provider Type
Individual
Full Name
Matos, John
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
10/5/2006
Last Updated
9/24/2021

Contact Information

Practice Location

1611 NW 12th Ave # 600b, Miami, FL 33136

(305) 355-1245

(305) 355-2244

Mailing Location

PO Box 12493, Miami, FL 33101-2493

(305) 585-5315

(305) 355-2242

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License ME102863 Florida
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License ME102863 Florida

Provider Identifiers

ID	Description	Issuer
ID 002199400	Description Medicaid	Issuer Unlisted Florida
ID P00760444	Description Other	Issuer RR MEDICARE PTAN Florida

John Matos

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Rao, Sanjana

Gonzalez, Samantha Marie

Anaya, Candido

Mendha, Taaha Amin

Ubu, Tobenna Uzoma

Ahmed, Madiha

Clauss, Stephanie Bromante

O'Connell, Mark T

Noy, Jose

Gaddipati, Neelima