Individual provider Active NPI

Russell D Metz, M.D.

  • Dermatology Physician
  • Ponte Vedra Beach, FL
National Provider Identifier
1174578348
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME0067703 Issued in FL
Practice address
103 Solana Road Suite B
Ponte Vedra Beach, FL 32082
Phone
(904) 273-2717
Fax
(904) 273-0410
NPI assigned
May 24, 2006
Last updated
Oct 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME0067703 FL Primary

Addresses

Primary practice location

103 Solana Road Suite B
Ponte Vedra Beach, FL 32082

Mailing address

103 Solana Road Suite B
Ponte Vedra Beach, FL 32082
Phone (904) 273-2717

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100310000538 FL Practitioner - Dermatology 7214908623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Emory University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaches Dermatology, P.a.Group PAC ID 9133190549, 15 clinicians

Practice addresses (Care Compare)

103 Solana Rd
Suite B
Ponte Vedra Beach, FL 32082-2231
Phone (904) 273-2717

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.79 of 100Reported as group
Quality
84.04
Promoting interoperability
100
Improvement activities
40
Cost
85.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision123
Removal of skin lesions1945
Removal of nail tissue1-10
Removal or shaving of skin growth79
Skin biopsy72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0067703FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaches Dermatology, P.a. Dermatology CurrentSince Jan 25, 2001 Accepting new patients

Locations

1545 S 14th St
Fernandina Beach, FL 32034
Phone (904) 202-4243

103 Solana Rd
Ponte Vedra Beach, FL 32082
Phone (904) 273-2717

103 Solana Rd
#B
Ponte Vedra Beach, FL 32082
Phone (904) 273-2717

614 E Twincourt Trl
St Augustine, FL 32095
Phone (904) 808-7107

Organizations & group practices 1

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1174578348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SOLANA ROAD SUITE B",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "32082",
            "telephone_number": "904-273-2717",
            "fax_number": "904-273-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SOLANA ROAD SUITE B",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "32082",
            "telephone_number": "904-273-2717",
            "fax_number": "904-273-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZ",
        "first_name": "RUSSELL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME0067703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

Verify at the official NPI Registry.