Individual provider Active NPI

Royce Mathew, P.A.C

  • Surgical Physician Assistant
  • Port Saint Lucie, FL
National Provider Identifier
1285033506
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
017786 Issued in NY
Practice address
9401 SW Discovery Way Ste 101
Port Saint Lucie, FL 34987-2381
Phone
(772) 288-2400
NPI assigned
Aug 22, 2014
Last updated
Dec 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9112762 FL
Physician Assistant 363A00000X 017786 NY
Medical Physician Assistant 363AM0700X 017786 NY
Surgical Physician Assistant 363AS0400X 017786 NY Primary

Addresses

Primary practice location

9401 SW Discovery Way Ste 101
Port Saint Lucie, FL 34987-2381

Mailing address

PO Box 22076
New York, NY 10087-2076
Phone (561) 657-4600

Other practice location 1

1050 SE Monterey Rd Ste 400
Stuart, FL 34994-4512
Phone (772) 288-2400

Other practice location 2

300 Palm Beach Lakes Blvd
West Palm Beach, FL 33401-2710
Phone (561) 657-4600

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address rmathew109633@direct.HSS.edu Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/ Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200124002079 FL Practitioner - Physician Assistant 3870818925 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSS-Florida Physicians LLCGroup PAC ID 5991032369, 60 clinicians

Practice addresses (Care Compare)

1050 SE Monterey Rd
Stuart, FL 34994-4512

1309 N Flagler Dr
West Palm BCH, FL 33401-3406
Phone (561) 655-5511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9112762FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Orthopaedics & Sports Medicine, PA CurrentSince Apr 1, 2022 Accepting new patients
South Florida Orthopaedics & Sports Medicine,PA Past Accepting new patients

Locations

9401 SW Discovery Way
Ste 101
Port St Lucie, FL 34987
Phone (772) 261-6824

1050 SE Monterey Rd
Ste 400
Stuart, FL 34994

Interoperability endpoints

  • Direct secure messaging: rmathew109633@direct.hss.edu
  • Direct secure messaging: royce.mathewpac.p1@direct.southflaortho.nextgenshare.com

Organizations & group practices 4

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 2

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": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1285033506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22076",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100872076",
            "telephone_number": "561-657-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SW DISCOVERY WAY STE 101",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872381",
            "telephone_number": "772-288-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 SE Monterey Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349944512",
            "country_code": "US",
            "telephone_number": "772-288-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Palm Beach Lakes Blvd",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334012710",
            "country_code": "US",
            "telephone_number": "561-657-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "ROYCE",
        "credential": "P.A.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-22",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112762",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017786",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "017786",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "017786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmathew109633@direct.HSS.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "300 Palm Beach Lakes Blvd",
            "city": "West Palm Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334012710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "300 Palm Beach Lakes Blvd",
            "city": "West Palm Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334012710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "300 Palm Beach Lakes Blvd",
            "city": "West Palm Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334012710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.