CHARLIE MATA (CRNA) – Certified Registered Nurse Anesthetist, NPI 1013663343

CHARLIE MATA (CRNA) is a healthcare provider. based in Virginia gardens, Florida. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 9347349 (FL). The NPI Number for CHARLIE MATA (CRNA) is 1013663343

Main info

Male
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
CHARLIE MATA (CRNA)
NPI
1013663343
Phone
(305) 469-6836
Address
6350 NW 37TH TER
Enumeration Date
24 February 2022
Last Update Date
21 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9544925728
Graduation Year
2024 (2 years ago)
PAC ID
5991230583
Group Practice PAC ID
1850298365
Professional Enrollment ID
I20241119003103
Address ID
FL333084603FT4725XDEPA601
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:4State licenses:2Digital endpointsOther names

5,359 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in FL

Provider Addresses for CHARLIE MATA (CRNA)

  • 6350 NW 37TH TER

    VIRGINIA GARDENS, FL 331667031

    Phone: (305) 469-6836

    Type: Mailing

  • 2006 HOGBACK RD

    SUITE 5A

    ANN ARBOR, MI 48105

    Phone: (734) 263-2414

    Fax: (734) 773-3471

    Type: Mailing

  • 4725 N. FEDERAL HWY

    FORT LAUDERDALE, FL 333084603

    Phone: (954) 771-8000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241119003103ICertified Registered Nurse Anesthetist (Crna)FLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33166)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850298365View full group profile
NameSpecialtyState
Thoracic Surgery, Cardiac SurgeryIN
-FL
O B S T E T R I C S/ G Y N E C O L O G YFL
General Practice, EndocrinologyFL
Orthopedic SurgeryFL
Anesthesiology, Pediatric MedicineFL
Anesthesiology AssistantFL
Pulmonary Disease, Internal MedicineFL
Internal MedicineFL
Physician AssistantFL

Reviews

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Frequently asked questions

Is CHARLIE MATA (CRNA) listed with a National Provider Identifier?
Yes — CHARLIE MATA (CRNA) has NPI 1013663343 on file in the registry.
Is CHARLIE MATA (CRNA) shown as active in public data?
Registry records indicate CHARLIE MATA (CRNA) maintains an active NPI.
What area of care is associated with CHARLIE MATA (CRNA)?
CHARLIE MATA (CRNA)'s record emphasizes Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where in Florida is CHARLIE MATA (CRNA) registered?
Use Virginia Gardens, Florida as the headline location for CHARLIE MATA (CRNA) here.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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