DR. MATTHEW RYAN DEBOER (DO) – Family Medicine Physician, NPI 1104047893

DR. MATTHEW RYAN DEBOER (DO) is a healthcare provider. based in Jacksonville, Florida. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. OS10998 (FL). The NPI Number for DR. MATTHEW RYAN DEBOER (DO) is 1104047893

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
DR. MATTHEW RYAN DEBOER (DO)
NPI
1104047893
Phone
(904) 202-1032
Address
PO BOX 44004
Enumeration Date
1 May 2007
Last Update Date
20 November 2024

Doctor Profile

Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Secondary Phone
9048244407
Graduation Year
2004 (22 years ago)
PAC ID
9133217557
Group Practice PAC ID
0648177733
Professional Enrollment ID
I20100708000837
Address ID
FL322590000ST1310X210X400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

6,723 FAMILY PRACTICE in FL

Provider Addresses for DR. MATTHEW RYAN DEBOER (DO)

  • PO BOX 44004

    JACKSONVILLE, FL 322314004

    Phone: (904) 202-1032

    Fax: (904) 824-7855

    Type: Mailing

  • 120 GATEWAY CIR UNIT 1

    CREDENTIALING DEPARTMENT

    JACKSONVILLE, FL 322594083

    Phone: (904) 824-4407

    Fax: (904) 824-7855

    Type: Location

  • PO BOX 746638

    ATLANTA, GA 303746638

    Phone: (904) 202-2092

    Fax: (904) 376-4075

    Type: Mailing

  • 1310 COUNTY ROAD 210 W

    SAINT JOHNS, FL 32259

    Phone: (904) 824-4407

    Fax: (904) 390-7459

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 104 Open Payments records for all available years, with a total value of $1,612.

Total Amount is formed as General ($1,612) + Research ($0) + Ownership ($0) = $1,612.

Last reported payment date: 2024-12-13 • Largest payer in this snapshot: ABBVIE INC. ($914).

Total Amount

$1,612

General + Research + Ownership

Payments

104

Total payment records

General Amount

$1,612

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-13

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2010-07-08

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
I20100708000837IFamily PracticeFLTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes252152$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit113113$0
G0444Annual depression screening, 5 to 15 minutes110110$0
G0442Annual alcohol misuse screening, 5 to 15 minutes109109$0
83036Hemoglobin a1c level3724$0
View full utilization report →

Insurance plans in this area (ZIP 32231)

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Provider's Procedures

DR. MATTHEW RYAN DEBOER (DO) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEFL90670Pneumococcal vaccine for injection into muscle2121

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: 0648177733View full group profile
NameSpecialtyState
Family PracticeFL
H O S P I T A L I S TUT
-UT
Hospitalist, Internal MedicineVA
Internal MedicineGA
Family PracticeUT
Hospitalist, Internal MedicineFL
H O S P I T A L I S TUT
R H E U M A T O L O G YUT
Hospitalist, Internal MedicineFL

Reviews

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Frequently asked questions

What is the standard ID for DR. MATTHEW RYAN DEBOER (DO) in the U.S.?
In the U.S., DR. MATTHEW RYAN DEBOER (DO) is identified by NPI 1104047893.
Is DR. MATTHEW RYAN DEBOER (DO)'s NPI status active today?
Active status means DR. MATTHEW RYAN DEBOER (DO)'s NPI record is not deactivated in the public file.
What does the directory say DR. MATTHEW RYAN DEBOER (DO) does?
Insurance directories may phrase it differently, but here DR. MATTHEW RYAN DEBOER (DO) maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. MATTHEW RYAN DEBOER (DO)?
DR. MATTHEW RYAN DEBOER (DO) is associated with Jacksonville, Florida in the same public data insurers reference.
Can I export DR. MATTHEW RYAN DEBOER (DO)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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