PENN L MATTOX PA-C
NPI 1104805001
Physician Assistant - Surgical in Orlando, FL
NPI Status: Active since January 10, 2006
Contact Information
4215 EDGEWATER DR
ORLANDO, FL
ZIP 32804
Phone: (407) 539-2000
Fax: (407) 398-0050
- Individual
- Female
- Physician Assistant
- Surgical
About PENN MATTOX
This page provides the complete NPI Profile along with additional information for Penn Mattox, a provider established in Orlando, Florida with a medical specialization in Physician Assistant, focusing in surgical . The healthcare provider is registered in the NPI registry with number 1104805001 assigned on January 2006. The practitioner's primary taxonomy code is 363AS0400X with license number PA380 (FL). The provider is registered as an individual and her NPI record was last updated 8 years ago.
- NPI
- 1104805001
- Provider Name
- PENN L MATTOX PA-C
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4215 EDGEWATER DR ORLANDO, FL 32804
- Location Phone
- (407) 539-2000
- Location Fax
- (407) 398-0050
- Mailing Address
- 1955 1ST AVENUE NORTH SUITE 101 SAINT PETERSBURG, FL 33713
- Mailing Phone
- (727) 822-3500
- Mailing Fax
- (407) 398-0050
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-10-2006
- Last Update Date
- 03-17-2018
- Code Navigator
Location Map
Secondary Locations
- 1955 1st Avenue North Suite 101
Saint Petersburg, FL 33713
(727) 822-3500
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Surgical
- Taxonomy Code
- 363AS0400X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- PA380
- License State
- FL
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | PA3280 (FL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2920905 00 | MEDICAID (05) | FL | |
| E4034Y | OTHER (01) | FL | FL MCARE - QSS SOUTHEAST CLINICAL SERVICES |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 0 | 4 | 8 | 0 | 5 | 0 | 0 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 0 | 4 | 16 | 0 | 10 | 0 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 0 + 4 + 1 + 6 + 0 + 1 + 0 + 0 + 0 + 24 = 39 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 40 - 39 = 1 | 1 | ||||||||
The NPI number 1104805001 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 14 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1518160779 | MR. STEPHEN E MCNALLY SR. CST CFA Individual | Specialist/Technologist, Other (Surgical Assistant) | 4215 EDGEWATER DR ORLANDO, FL 32804 (407) 539-2000 |
| 1437144953 | RICHARD KENT CHAPMAN PA C Individual | Physician Assistant (Surgical) | 4215 EDGEWATER DR ORLANDO, FL 32804 (407) 539-2000 |
| 1457345449 | CHRISTOPHER J KONDOR PA C Individual | Physician Assistant (Surgical) | 4215 EDGEWATER DR ORLANDO, FL 32804 (407) 539-2000 |
| 1407884950 | KENNETH E. BAKER PA-C Individual | Physician Assistant | 4215 EDGEWATER DR ORLANDO, FL 32804 (407) 539-2000 |
| 1114000676 | MICHELLE A PETTIT PAC Individual | Physician Assistant | 4215 EDGEWATER DR ORLANDO, FL 32804 (973) 826-8291 |
| 1306916572 | MR. WILBERTO OLIVERA PA-C Individual | Physician Assistant (Surgical) | 4215 EDGEWATER DR ORLANDO, FL 32804 (973) 826-8291 |
| 1588903108 | COLLEEN REGES PA-C Individual | Physician Assistant (Medical) | 4215 EDGEWATER DR ORLANDO, FL 32804 (973) 826-8291 |
| 1043272255 | MICHAEL EDWARD HAMMOOR PA-C Individual | Physician Assistant (Surgical) | 4215 EDGEWATER DR ORLANDO, FL 32804 (407) 539-2000 |
| 1497901029 | ANTHONY ALLEN MOORE PA Individual | Physician Assistant | 4215 EDGEWATER DR ORLANDO, FL 32804 (855) 582-7747 |
| 1609854876 | PAMELA JEAN STOIKE PAC Individual | Physician Assistant (Surgical) | 4215 EDGEWATER DR ORLANDO, FL 32804 (973) 826-8080 |
| 1689964462 | KATRINA J SMITH P.A. Individual | Physician Assistant (Surgical) | 4215 EDGEWATER DR ORLANDO, FL 32804 (973) 826-8080 |
| 1740521137 | QSS-SOUTHEAST CLINICAL SERVICES LLC Organization | Surgery | 4215 EDGEWATER DR ORLANDO, FL 32804 (407) 539-2000 |
| 1487684528 | DAVID M GONDEK PA-C Individual | Physician Assistant (Surgical) | 4215 EDGEWATER DR ORLANDO, FL 32804 (407) 539-2000 |
| 1083968820 | DENISE M LIVINGSTON ARNP Individual | Nurse Practitioner (Adult Health) | 4215 EDGEWATER DR ORLANDO, FL 32804 (407) 539-2000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104805001, enumerated in the NPI registry as an "individual" on January 10, 2006
The provider is located at 4215 Edgewater Dr Orlando, Fl 32804 and the phone number is (407) 539-2000
The provider's speciality is Physician Assistant with taxonomy code 363AS0400X with a focus in Surgical
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on January 10, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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