Ponte Vedra Plastic Surgery, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PONTE VEDRA PLASTIC SURGERY, INC

Practice address

209 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600

Phone

(904) 273-6200

Fax

(904) 280-8013

NPI assigned

Mar 14, 2008

Last updated

Apr 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Robin Solomon

Title

Director

Phone

(904) 273-6200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert W. Burk III, M.D.

  • Specialist
  • Ponte Vedra Beach, FL
  • NPI 1174630644
  Medicare reassignment Care Compare group NPD
• Ellen Hancock, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Ponte Verda Beach, FL
  • NPI 1316392905
  Medicare reassignment Care Compare group NPD
• Hollie Jo Hickman, D.O.

  • Surgery Physician
  • Jacksonville, FL
  • NPI 1427032390
  Medicare reassignment Care Compare group NPD
• Matthew Mitchell, MD

  • Plastic and Reconstructive Surgery Physician
  • St Augustine, FL
  • NPI 1164955761
  Medicare reassignment Care Compare group NPD
• Erez Gabriel Sternberg, M.D.

  • Plastic Surgery Physician
  • Jacksonville, FL
  • NPI 1881678753
  Medicare reassignment Care Compare group NPD
• Abby Lauren Threet, MD

  • Plastic and Reconstructive Surgery Physician
  • Ponte Vedra Beach, FL
  • NPI 1992200224
  Medicare reassignment Care Compare group NPD
• Christopher Michael Bates, MD

  • Plastic and Reconstructive Surgery Physician
  • Laguna Beach, WA
  • NPI 1730524596

  FL

  Medicare reassignment Care Compare group NPD
• Brett J. Snyder, M.D.

  • Plastic Surgery Physician
  • Ponte Vedra Beach, FL
  • NPI 1053428466

  Specialist

  Medicare reassignment NPD

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1841461100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 PONTE VEDRA PARK DRIVE",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "32082",
            "telephone_number": "904-273-6200",
            "fax_number": "904-280-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 PONTE VEDRA PARK DR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320826600",
            "telephone_number": "904-273-6200",
            "fax_number": "904-280-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONTE VEDRA PLASTIC SURGERY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "SOLOMON",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-273-6200",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE/PALMETTO GPA",
            "identifier": "CC8991",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ponte Vedra Family Dentistry
• Ponte Vedra Family Dentistry
• Ponte Vedra Neuropsychology LLC
• Ponte Vedra Orthodontics LLC
• Ponte Vedra Physical Therapy, Inc.
• Ponte Vedra Psychiatry LLC
• Ponte Vedra Psychologists, LLC
• Ponte Vedra Spine Center LLC
• Ponte Vedra Surgery Center
• Ponte Vedra Wellness Center Inc

• Specialist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.