Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. OTAKHON MATCHANOV MD
NPI 1578158333
Hospitalist in Fort Myers, FL

Q: What is Otakhon Matchanov's NPI number?

The NPI number for Otakhon Matchanov is 1578158333. It was assigned to this individual provider in the NPPES registry on March 3, 2021.

Q: What is Otakhon Matchanov's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Otakhon Matchanov was last updated on July 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 03, 2021PECOS Enrolled

12600 CREEKSIDE LN STE 2, FORT MYERS, FL 33919(239) 343-9235 Get Directions Write a Review

NPPES record last updated: July 31, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 31, 2026, Jul 24, 2026, Jan 13, 2026 and 2 more (5 updates tracked since 2021).

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About Dr. Otakhon Matchanov Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. OTAKHON MATCHANOV MD (NPI 1578158333) is an individual hospitalist provider in Fort Myers, Florida, licensed in Florida (ME182444) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS and maintains a secondary practice location in New York.

NPPES Registry Identity

NPI1578158333

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameDR. OTAKHON MATCHANOVCredential: MD

Location Address12600 CREEKSIDE LN STE 2Fort Myers, FL 33919-3353

Mailing AddressPo Box 2147Fort Myers, FL 33902-2147 · (239) 343-9235 · Fax (239) 343-4008

Phone(239) 343-9235

Sole ProprietorYes

Enumeration DateMarch 3, 2021

Last NPPES UpdateJuly 31, 20265 updates tracked since enumeration

NPPES CertifiedJuly 31, 2026

✔ NPI 1578158333 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in FL · ME182444

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedPsychiatry & Neurology · Clinical NeurophysiologyTaxonomy 2084N0600X · License 338571-01 (NY)

12600 CREEKSIDE LN STE 2, Fort Myers, FL 33919

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Secondary Practice Location 1

Location 1100 E 77th StNew York, NY 10075-1850 · Phone (212) 434-6400

Other Identifiers 1

Medicaid131804200FL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Otakhon Matchanov Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33919 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$135.56 typical visit price

range $58.56 – $179.05

Typical copayment $33.89 (range $14.64 – $44.76)

Most-billed visit code 99204

Established Patient

$103.21 typical visit price

range $18.44 – $144.68

Typical copayment $25.80 (range $4.61 – $36.17)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PHU LE M.D.

Psychiatry & Neurology (Neurology)