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PONTE VEDRA PLASTIC SURGERY, INC
NPI 1841461100
Specialist in Ponte Vedra Beach, FL

Active since March 14, 2008CLIA Certified · 2 labs
209 PONTE VEDRA PARK DR, PONTE VEDRA BEACH, FL 32082(904) 273-6200(904) 280-8013 Get Directions Write a Review

NPPES record last updated: April 25, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ponte Vedra Plastic Surgery, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PONTE VEDRA PLASTIC SURGERY, INC (NPI 1841461100) is a healthcare organization registered as a specialist in Ponte Vedra Beach, Florida and active in the NPI registry since March 2008. The organization holds 2 active CLIA laboratory certificates and lists Robin Solomon, Director, as its authorized official.

NPPES Registry Identity

NPI1841461100
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NamePONTE VEDRA PLASTIC SURGERY, INC
Location Address209 PONTE VEDRA PARK DRPonte Vedra Beach, FL 32082-6600
Mailing Address209 Ponte Vedra Park DrivePonte Vedra Beach, FL 32082 · (904) 273-6200 · Fax (904) 280-8013
Phone(904) 273-6200
Fax(904) 280-8013
Organization SubpartNo
Authorized OfficialRobin SolomonDirector · (904) 273-6200
Enumeration DateMarch 14, 2008
Last NPPES UpdateApril 25, 2024
NPPES CertifiedApril 25, 2024
✔ NPI 1841461100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
209 PONTE VEDRA PARK DR, Ponte Vedra Beach, FL 32082
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Other Identifiers 1

OtherCC8991FL · Railroad Medicare/palmetto Gpa

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ponte Vedra Plastic Surgery, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Ponte Vedra Plastic Surgery, Inc, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Abby Threet, MD
Plastic and Reconstructive Surgery
NPI 1992200224
209 PONTE VEDRA PARK DR
Ponte Vedra Beach, FL 32082
(256) 762-2351
✔ PECOS✔ Accepts MedicareSame address
Robert Burk, M.D.
Plastic and Reconstructive Surgery
NPI 1174630644
209 PONTE VEDRA PARK DR
Ponte Vedra Beach, FL 32082
(904) 273-6200
✔ PECOS✔ Accepts MedicareSame address
Brett Snyder, M.D.
Plastic and Reconstructive Surgery
NPI 1053428466
209 PONTE VEDRA PARK DR
Ponte Vedra Beach, FL 32082
(904) 273-6200
✔ PECOSSame address
Ellen Hancock, M.D.
Plastic and Reconstructive Surgery
NPI 1316392905
209 PONTE VEDRA PARK DR.
Ponte Verda Beach, FL 32082
(904) 273-6200
✔ PECOS✔ Accepts MedicareSame address
Erez Sternberg, M.D.
Plastic and Reconstructive Surgery
NPI 1881678753
7711 BAYMEADOWS RD E SUITE #6
Jacksonville, FL 32256
(904) 638-5555
✔ PECOS✔ Accepts Medicare7.3 mi
Matthew Mitchell, MD
Plastic and Reconstructive Surgery
NPI 1164955761
304 ASHOURIAN AVE STE 107
Saint Augustine, FL 32092
(904) 657-4103
✔ PECOS✔ Accepts Medicare15 mi
Hollie Hickman, D.O.
Plastic and Reconstructive Surgery
NPI 1427032390
655 W 8TH ST
Jacksonville, FL 32209
(904) 633-0130
✔ PECOS✔ Accepts Medicare18 mi
Christopher Bates, MD
Plastic and Reconstructive Surgery
NPI 1730524596
31852 PACIFIC COAST HWY SUITE 401
Laguna Beach, WA 92651
(949) 499-2800
✔ PECOS✔ Accepts Medicare2,138 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2216567

Ponte Vedra Plastic Surgery · Ponte Vedra Beach, FL
Active · expires Mar 14, 2027
CLIA Number10D2216567
Laboratory TypePharmacy
Certificate Effective DateMarch 15, 2025
Certificate Expiration DateMarch 14, 2027
Laboratory DirectorErez Stetnberg
Laboratory Phone(904) 273-6200
Laboratory LocationPonte Vedra Plastic Surgery209 Ponte Vedra Park Drive, Ponte Vedra Beach, FL 32082
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2140378

Ponte Vedra Plastic Surgery · Jacksonville, FL
Active · expires Nov 20, 2027
CLIA Number10D2140378
Laboratory TypeSurgery Facility
Certificate Effective DateNovember 21, 2025
Certificate Expiration DateNovember 20, 2027
Laboratory DirectorHollie Jo Hickman
Laboratory Phone(904) 273-6200
Laboratory LocationPonte Vedra Plastic Surgery11512 Lake Mead Ave Suites 511 - 514, Jacksonville, FL 32216
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ponte Vedra Plastic Surgery, Inc's NPI number?

The NPI number for Ponte Vedra Plastic Surgery, Inc is 1841461100. It was assigned to this organization in the NPPES registry on March 14, 2008.

Where is Ponte Vedra Plastic Surgery, Inc located?

Ponte Vedra Plastic Surgery, Inc is located at 209 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082. The listed phone number is (904) 273-6200.

What is Ponte Vedra Plastic Surgery, Inc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Ponte Vedra Plastic Surgery, Inc enrolled in Medicare?

Yes. Ponte Vedra Plastic Surgery, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ponte Vedra Plastic Surgery, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians, all in Plastic and Reconstructive Surgery, reassign their Medicare billing to Ponte Vedra Plastic Surgery, Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Ponte Vedra Plastic Surgery, Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Ponte Vedra Plastic Surgery, Inc accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Ponte Vedra Plastic Surgery, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ponte Vedra Plastic Surgery, Inc was last updated on April 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.