Active NPI
Matthew Thomas Smith, DO
- Surgery Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 34.011481
- Practice address
- 14540 Old Saint Augustine Rd Ste 2571
Jacksonville, FL 32258-7420 - Phone
- (904) 886-2251
- Fax
- (904) 886-7151
- NPI assigned
- Jun 14, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 34.011481 | OH | Primary |
Addresses
Primary practice location
14540 Old Saint Augustine Rd Ste 2571
Jacksonville, FL 32258-7420
Mailing address
11945 San Jose Blvd Ste 300
Jacksonville, FL 32223-1627
Phone (904) 396-1725
Other practice location 1
307 Boatner Rd Ste 114
Eglin AFB, FL 32542
Phone (850) 883-8505
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- West Virginia School of Osteopathic Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
14540 Old Saint Augustine Rd
Suite 2571
Jacksonville, FL 32258-7420
Phone (904) 886-2251
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.64 of 100
- Quality
- 79.34
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 44 |
| Mastectomy | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Florida Surgeons, PA | Current | Accepting new patients | |
| North Florida Surgeons, PA | Surgery | Current | Accepting new patients |
Locations
11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223
14540 Old St Augustine Rd
Ste 2571
Jacksonville, FL 32258
Phone (904) 886-2251
11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937
836 Prudential Dr
Ste 1001
Jacksonville, FL 32207
Phone (904) 398-0004
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Interoperability endpoints
- matthew.smith.1@9109.direct.athenahealth.com
- msmith770958@direct.shands.ufl.edu
Organizations & group practices 2
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.
-
- Surgery Physician
- Jacksonville, FL
- NPI 1912953290
-
- Orthopaedic Surgery Physician
- Gulf Breeze, FL
- NPI 1871442053
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jacksonville Beach, FL
- NPI 1821155912
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1578620449
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564617600000",
"number": "1144541152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11945 SAN JOSE BLVD STE 300",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322231627",
"telephone_number": "904-396-1725",
"fax_number": "904-396-4893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14540 OLD SAINT AUGUSTINE RD STE 2571",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322587420",
"telephone_number": "904-886-2251",
"fax_number": "904-886-7151"
}
],
"practiceLocations": [
{
"address_1": "307 Boatner Rd Ste 114",
"address_purpose": "LOCATION",
"city": "Eglin AFB",
"state": "FL",
"postal_code": "32542",
"country_code": "US",
"telephone_number": "850-883-8505",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "MATTHEW",
"middle_name": "THOMAS",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-14",
"last_updated": "2019-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OH",
"license": "34.011481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.