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Active NPI 1164955761 Individual Practitioner Male Practitioner

Dr. Matthew Mitchell , MD

Surgery - Plastic and Reconstructive Surgery • Saint Augustine, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Matthew Mitchell, MD is a certified Surgery - Plastic and Reconstructive Surgery practicing in Saint Augustine, FL. With approximately 9 years of clinical experience since completing medical education in 2017, Dr. Mitchell delivers high-quality medical care to the local community at 304 ASHOURIAN AVE STE 107.

Dr. Mitchell is affiliated with Ponte Vedra Plastic Surgery, Inc. and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

304 Ashourian Ave Ste 107

Saint Augustine, FL 320925110

Telephone 9046574103
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2017

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery - Plastic and Reconstructive Surgery in Saint Augustine, FL

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
9 Yrs Matches City Avg
City Avg: 9.0 Yrs
State Avg: 25.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Saint Augustine, FL (258 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mitchell (9 Years) 9 Yrs
Saint Augustine Specialty Average (9.0 Years) 9.0 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-06-10
Surgery - Plastic and Reconstructive Surgery Primary Specialty

NUCC Taxonomy Code: 2086S0122X

State License FL ME159355

A surgeon who specializes in plastic and reconstructive surgery.

Hospital & Practice Group Affiliations

Ponte Vedra Plastic Surgery, Inc.

209 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 320826600

Phone: 9042736200

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Practice Location June 10, 2026

Registered at 304 ASHOURIAN AVE STE 107, SAINT AUGUSTINE, FL 320925110 (Tel: 9046574103)

📍
Updated Business Mailing Address June 10, 2026

Registered at 304 ASHOURIAN AVE STE 107, SAINT AUGUSTINE, FL 320925110 (Tel: 9046574103)

📍
Updated Practice Location July 17, 2024

Registered at 209 PONTE VEDRA PARK DR, PONTE VEDRA BEACH, FL 320826600 (Tel: 9042736200)

📍
Updated Business Mailing Address July 17, 2024

Registered at 209 PONTE VEDRA PARK DR, PONTE VEDRA BEACH, FL 320826600 (Tel: 9042736200)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 17, 2024

Surgery (License #ME159355 in FL)

📍
Updated Practice Location June 23, 2021

Registered at 545 BARNHILL DR STE 232, INDIANAPOLIS, IN 462025112 (Tel: 3172780394)

📍
Updated Business Mailing Address June 23, 2021

Registered at 545 BARNHILL DR, EMERSON HALL 232, INDIANAPOLIS, IN 462025112 (Tel: 3172780394)

👤
Provider Name / Credentials Updated June 23, 2021

Recorded as MATTHEW MITCHELL, MD

NPI Profile Active April 10, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location April 10, 2017

Registered at 920 MADISON AVE, SUITE 447, MEMPHIS, TN 381033438 (Tel: 9014481350)

📍
Updated Business Mailing Address April 10, 2017

Registered at 910 MADISON AVE, SUITE 315, MEMPHIS, TN 381033403 (Tel: 9014481350)

👤
Provider Name / Credentials Updated April 10, 2017

Recorded as MATTHEW MITCHELL

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 10, 2017

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 10, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164955761
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 10, 2017
Last Update: June 10, 2026
Sole Proprietor: No

Mailing Address

304 Ashourian Ave Ste 107

Saint Augustine, FL 320925110

Phone: 9046574103

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.