Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Matthew Mitchell, MD

Individual provider Plastic and Reconstructive Surgery Physician · NPI 1164955761

Matthew Mitchell, MD is a Plastic and Reconstructive Surgery in Saint Augustine, Florida. Qualified in 2017, 9 years ago. Practices with Ponte Vedra Plastic Surgery, Inc, a 7-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
9
Licensed in
FL
In the registry since
2017
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

304 Ashourian Ave Ste 107
Saint Augustine, FL 32092-5110
Phone: (904) 657-4103
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic and Reconstructive Surgery Physician (primary) Taxonomy 2086S0122X · Licence ME159355 (FL)

Record details

NPI number1164955761
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 10, 2017
Last updated in NPPESJune 10, 2026
Certification dateJune 10, 2026
Mailing address304 Ashourian Ave Ste 107, Saint Augustine, FL 32092-5110

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Ponte Vedra Plastic Surgery, Inc. — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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