Matthew Montgomery, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PENDING Issued in FL

Practice address

45 Groover Loop Ste 201
Saint Augustine, FL 32086-6586

Phone

(904) 634-0640

NPI assigned

Mar 18, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Orthopedic Specialists LLCGroup PAC ID 1456246974, 144 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brooks Rehabilitation Home Health Home health agency, Jacksonville, FL, CCN 103174
• Ascension St Vincent'S St Johns County Hospital, St. Johns, FL, CCN 100361
• Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
• Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.montgomery.1@22724.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southeast Orthopedic Specialists, LLC

  • Orthopaedic Surgery Physician
  • Jacksonville, FL
  • NPI 1629025820
  Medicare reassignment Care Compare group NPD
• Southeast Orthopedic Specialists, LLC

  • Durable Medical Equipment & Medical Supplies
  • St Johns, FL
  • NPI 1538952379
  NPD
• Center for Orthopedic Research and Education, LLC

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
  • NPI 1427095801

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brooks Home Care Advantage, Inc.

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1184895740
  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1376114413

  Inpatient rehabilitation facility

  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1912947748

  Inpatient rehabilitation facility

  Care Compare affiliation
• St Lukes - St Vincents Healthcare

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation
• St Vincents Health System Inc

  • General Acute Care Hospital
  • St. Johns, FL
  • NPI 1861078651
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1114727153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SOUTHPOINT PKWY STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168203",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 GROOVER LOOP STE 201",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320866586",
            "telephone_number": "904-634-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127049200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monarch Mobile Physical Therapy LLC
• Danielle Lane Montana, L.C.S.W.
• Idalia Montanez-Miranda, PSY.D.
• Montgomery and Associates MD
• Daniele J Montgomery, MD
• Tracy Montoya, RDH
• Raul A Monzon, MD
• Elisabeth Anne Moody, MS CCC-SLP
• Anna Moon Farrell, MS., CCC-SLP
• Melissa S Moon, MOTR

• Physician Assistant in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.