MR. RANDALL T MATHIS PA-C
NPI 1922055391
Physician Assistant - Surgical in St Augustine, FL

Q: What is Randall Mathis's NPI number?

The NPI number for Randall Mathis is 1922055391. It was assigned to this individual provider in the NPPES registry on May 30, 2006.

Q: What is Randall Mathis's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Randall Mathis was last updated on April 16, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 30, 2006PECOS Enrolled

100 WHETSTONE PL, STE 310, ST AUGUSTINE, FL 32086(904) 217-7450(904) 217-7483 Get Directions Write a Review

NPPES record last updated: April 16, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mr. Randall T Mathis Pa-c NPPES

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

MR. RANDALL T MATHIS PA-C (NPI 1922055391) is an individual surgical provider in St Augustine, Florida, licensed in Florida (PA9101202) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1922055391

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameMR. RANDALL T MATHISCredential: PA-C

Location Address100 WHETSTONE PL, STE 310St Augustine, FL 32086-5774

Mailing AddressPo Box 3123St Augustine, FL 32085-3123 · (904) 217-7450 · Fax (904) 217-7483

Phone(904) 217-7450

Fax(904) 217-7483

Sole ProprietorNo

Enumeration DateMay 30, 2006

Last NPPES UpdateApril 16, 2012

✔ NPI 1922055391 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in FL · PA9101202

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA9101202 (FL)

100 WHETSTONE PL, St Augustine, FL 32086

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Other Identifiers 3

OtherY04HBFL · Bcbs

Medicaid004707900FL

Medicare PINE3585TFL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Randall T Mathis Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

100%63 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.