Individual provider Active NPI

Abby Lauren Threet, MD

  • Plastic and Reconstructive Surgery Physician
  • Ponte Vedra Beach, FL
National Provider Identifier
1992200224
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME168347 Issued in FL
Practice address
209 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600
Phone
(256) 762-2351
NPI assigned
Mar 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Plastic and Reconstructive Surgery Physician 2086S0122X ME168347 FL Primary

Addresses

Primary practice location

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

Mailing address

17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Phone (813) 250-2506

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250314003534 FL Practitioner - Plastic and Reconstructive Surgery 9537681804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Alabama School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ponte Vedra Plastic Surgery, Inc.Group PAC ID 5890786701, 7 clinicians

Practice addresses (Care Compare)

209 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600
Phone (904) 273-6200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ponte Vedra Plastic Surgery, Inc CurrentSince Dec 27, 2024 Accepting new patients

Locations

11512 Lake Mead Ave
Unit 513
Jacksonville, FL 32256
Phone (904) 402-8346

209 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082
Phone (904) 273-6200

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1992200224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 DAVIS BLVD STE 308",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063438",
            "telephone_number": "813-250-2506"
        },
        {
            "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": "256-762-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THREET",
        "first_name": "ABBY",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME168347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

Verify at the official NPI Registry.