Byron Tyrell Mathis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9011 Issued in GA

Practice address

4720 Washington Rd
Evans, GA 30809-5875

Phone

(706) 650-0111

Fax

(706) 651-1882

NPI assigned

Oct 9, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, SC2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

90.28 of 100Reported as group

Quality

82.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bmathis543419@selfregional.direct-ci.net
• Direct secure messaging: bmathis@augustaent.emadirect.md

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.

• Urgent MD Healthcare Services, P.C.

  • Family Medicine Physician
  • Grovetown, GA
  • NPI 1053482273
  Medicare reassignment NPD
• Self Regional Healthcare Partners

  • Critical Access Hospital
  • Edgefield, SC
  • NPI 1922582105
  Medicare reassignment
• Augusta ENT PC

  • Specialist
  • Evans, GA
  • NPI 1770649204
  NPD
• Urgent MD Healthcare Services, P.C.

  • Gynecology Physician
  • Augusta, GA
  • NPI 1427586023
  NPD
• Augusta ENT PC

  • Otolaryngology Physician
  • Aiken, SC
  • NPI 1679945661
  NPD
• Self Regional Healthcare Partners

  • Community/Retail Pharmacy
  • Edgefield, SC
  • NPI 1073486494
  NPD
• Self Regional Healthcare Partners

  • Medicare Defined Swing Bed Hospital Unit
  • Edgefield, SC
  • NPI 1780168971
  NPD

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1578038337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 SILVER BLUFF RD",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298035879",
            "telephone_number": "803-648-0587",
            "fax_number": "803-648-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 WASHINGTON RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308095875",
            "telephone_number": "706-650-0111",
            "fax_number": "706-651-1882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Ridge Medical Plaza Rd",
            "address_purpose": "LOCATION",
            "city": "Edgefield",
            "state": "SC",
            "postal_code": "298244531",
            "country_code": "US",
            "telephone_number": "803-637-3146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "BYRON",
        "middle_name": "TYRELL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-09",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "3107",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3850PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Butler Martin, LCSW, MAC
• Kayleigh Martinez, RBT
• Saintete' Carter Martinez, DOULA
• Abby Mason
• Jordan Paul Mason, FNP
• Larry Mathis
• Lauren Mathis, N.P.
• Jade Matthews-Rosado, OTD
• Mary Anna Maynard, LPC
• Cassidy Robin McCann

• Physician Assistant in Evans, GA
• Providers in Evans, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.