Active NPI
Mitchell Gerald Plana Barros
- Physician Assistant
- Saint Augustine, FL
National Provider Identifier
1851804553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 400 Health Park Blvd
Saint Augustine, FL 32086-5784 - Phone
- (904) 819-5155
- NPI assigned
- Nov 16, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 35921 | FL | |
| Physician Assistant | 363A00000X | FL | Primary | |
| Physical Therapist | 225100000X | 294088 | CA |
Addresses
Primary practice location
400 Health Park Blvd
Saint Augustine, FL 32086-5784
Mailing address
1301 Plantation Island Dr S Ste 102B
Saint Augustine, FL 32080-3110
Phone (904) 315-2881
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251104004784 | FL | Practitioner - Physician Assistant | 8820402373 |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1 Zotec Way
Carmel, IN 46032-0052
PO Box
Atlanta, GA 30374
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 294088 | CA | MD | Physical Therapist |
| 35921 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747958400000",
"number": "1851804553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 PLANTATION ISLAND DR S STE 102B",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320803110",
"telephone_number": "904-315-2881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 HEALTH PARK BLVD",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320865784",
"telephone_number": "904-819-5155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARROS",
"first_name": "MITCHELL GERALD",
"middle_name": "PLANA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-11-16",
"last_updated": "2025-05-23",
"certification_date": "2025-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "35921",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": null,
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "294088",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.