Individual provider Active NPI

Victoria Mathis, PA-C

  • Surgical Physician Assistant
  • Altamonte Springs, FL
National Provider Identifier
1518591312
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9112913 Issued in FL
Practice address
661 E Altamonte Dr Ste 231
Altamonte Springs, FL 32701-5102
Phone
(407) 303-5214
Fax
(407) 303-5215
NPI assigned
Mar 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9112913 FL
Surgical Physician Assistant 363AS0400X PA9112913 FL Primary

Addresses

Primary practice location

661 E Altamonte Dr Ste 231
Altamonte Springs, FL 32701-5102

Mailing address

1815 Honeydew CT
Ocoee, FL 34761-7705
Phone (937) 313-3734

Other names 1

  • Victoria Faith Thomson Former name

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
I20200519001940 FL Practitioner - Physician Assistant 6608207063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

631 E Altamonte Dr
Suite 231
Altamonte Springs, FL 32701-4802
Phone (407) 303-5214

661 E Altamonte Dr
Altamonte Springs, FL 32701-5102

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9112913FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Jun 8, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jun 8, 2020 Accepting new patients

Locations

661 E Altamonte Dr
Ste 231
Altamonte Springs, FL 32701
Phone (407) 303-5214

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: vmathis73923@adventhealth.direct-ci.com

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.

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": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1518591312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 HONEYDEW CT",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347617705",
            "telephone_number": "937-313-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 E ALTAMONTE DR STE 231",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015102",
            "telephone_number": "407-303-5214",
            "fax_number": "407-303-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "VICTORIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112913",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9112913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "THOMSON",
            "middle_name": "FAITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.