Daniel Ricardo Matta (NPI# 1073950200, PAC ID# 2062729239) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1073950200 |
| PAC ID by PECOS | 2062729239 |
| Professional Enrollment ID | I20190201002686 |
| Full Name | Daniel Ricardo Matta |
| Organization Legal Name | SOUTHLAND HOSPITALIST GROUP, LLC |
| Address |
915 Gordon Ave Thomasville GA 31792-6614 |
| Phone Number | 2292282000 |
| Gender | M |
| Medical School | UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 8022272913 |
| Number of Group Practice Members | 24 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110038 | JOHN D ARCHBOLD MEMORIAL HOSPITAL |
| 100135 | TALLAHASSEE MEMORIAL HEALTHCARE |
| 110132 | MEMORIAL HOSPITAL AND MANOR |
| Address | Phone | Organization |
|---|---|---|
| 915 Gordon Ave, Thomasville, GA 31792-6614 | 2292282000 | SOUTHLAND HOSPITALIST GROUP, LLC |
| Organization Legal Name | SOUTHLAND HOSPITALIST GROUP, LLC |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jason Griffin | Family Medicine | Southland Hospitalist Group, LLC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Rudolf J Hehn | Family Medicine | Southland Hospitalist Group, LLC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| David Mederos | Internal Medicine | Southland Hospitalist Group, LLC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Laneau Hayes | Internal Medicine | Southland Hospitalist Group, LLC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Shaun Hoenstine | Internal Medicine | Southland Hospitalist Group, LLC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Matthew Graham | Internal Medicine | Southland Hospitalist Group, LLC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Richard Pearson Jr. | Internal Medicine | Southland Hospitalist Group, LLC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Brandon R Bergan | Internal Medicine | Southland Hospitalist Group, LLC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Sarah Vocelle | Internal Medicine | Southland Hospitalist Group, LLC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Kristin Seals Benefield | Nurse Practitioner | Southland Hospitalist Group, LLC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Street Address |
915 GORDON AVE |
| City | THOMASVILLE |
| State | GA |
| Zip | 31792-6614 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Keerthi Kiran Ponugoti | Pulmonary Disease | John D. Archbold Memorial Hospital, Inc. | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Edward L Hall Jr. | General Surgery | Archbold Medical Group, Inc. | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Jason Griffin | Family Medicine | Southland Hospitalist Group, LLC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| William W Ellis | Cardiovascular Disease (cardiology) | John D. Archbold Memorial Hospital, Inc. | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Michael Quinif | Anesthesiology | South Georgia Anesthesia Associates, PC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Richard W Murphy Jr. | Orthopedic Surgery | Thomasville Orthopedic Center, PC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Melissa H Porter | Physician Assistant | Archbold Medical Group, Inc. | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Edward Truman Wright Iii | Pathology | Pathology Associates, P.C. | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Winston C Connell | Emergency Medicine | Decatur Emergency Physicians LLC | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Robert D Miles Jr. | Cardiovascular Disease (cardiology) | John D. Archbold Memorial Hospital, Inc. | 915 Gordon Ave, Thomasville, GA 31792-6614 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stanley B Allen | Physician Assistant | Archbold Medical Group, Inc. | 401 Old Albany Rd, Thomasville, GA 31792-4014 |
| James A Thompson | Certified Clinical Nurse Specialist (cns) | John D. Archbold Memorial Hospital, Inc. | 401 Old Albany Rd, Thomasville, GA 31792-4014 |
| Felicia M Yearby | Nurse Practitioner | John D. Archbold Memorial Hospital, Inc. | 401 Old Albany Rd, Thomasville, GA 31792-4014 |
| Ann T Lucas | Clinical Psychologist | John D. Archbold Memorial Hospital, Inc. | 401 Old Albany Rd, Thomasville, GA 31792-4014 |
| Todd A Hanscom | Chiropractic | 409 E Jackson St, Thomasville, GA 31792-4615 | |
| David A Miller | Physical Medicine and Rehabilitation | 421 E Jackson St, Thomasville, GA 31792-4694 | |
| Albert I Richardson | General Surgery | Southern Vascular Specialists, LLC | 1019 E Jackson St, Thomasville, GA 31792-4789 |
| Karen B Lee | Nurse Practitioner | Southern Vascular Specialists, LLC | 1019 E Jackson St, Thomasville, GA 31792-4789 |
| Stephen W Pearce | Certified Registered Nurse Anesthetist (crna) | Georgia-florida Eye Centers, P.C. | 2282 E Pine Tree Boulevard, Thomasville, GA 31792-4807 |
| Robert D Webb | Ophthalmology | Georgia-florida Eye Centers, P.C. | 2282 E Pine Tree Boulevard, Thomasville, GA 31792-4807 |
| Find all physicians in zip 31792 | |||
| City | THOMASVILLE |
| Zip Code | 31792 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | THOMASVILLE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Daniel Ricardo Matta.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.