MARY STEPHENS MATHIS (PA-C) – Physician Assistant, NPI 1053446690
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
Provider Addresses for MARY STEPHENS MATHIS (PA-C)
PO BOX 45443
SALT LAKE CITY, UT 841450443
Phone: (904) 202-1032
Fax: (904) 376-3107
Type: Mailing
120 GATEWAY CIR
UNIT 1
JACKSONVILLE, FL 322594082
Phone: (904) 824-4407
Fax: (904) 824-7855
Type: Location
PO BOX 746638
ATLANTA, GA 303746638
Phone: (904) 202-1032
Fax: (904) 376-3107
Type: Mailing
1310 COUNTY ROAD 210 W
SAINT JOHNS, FL 32259
Phone: (904) 824-4407
Fax: (904) 390-7459
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 99 Open Payments records for all available years, with a total value of $1,668.
Total Amount is formed as General ($1,668) + Research ($0) + Ownership ($0) = $1,668.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: ABBVIE INC. ($885).
Total Amount
$1,668
General + Research + Ownership
Payments
99
Total payment records
General Amount
$1,668
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $885 |
| Novo Nordisk Inc | $137 |
| Lilly USA, LLC | $122 |
| ViiV Healthcare Company | $107 |
| PFIZER INC. | $59 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-03-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110316000177 | I | Physician Assistant | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 91 | 71 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 13 | 13 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 11 | 11 | $0 |
Insurance plans in this area (ZIP 84145)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | FL | |
| H O S P I T A L I S T | UT | |
| - | UT | |
| Hospitalist, Internal Medicine | VA | |
| Internal Medicine | GA | |
| Family Practice | UT | |
| Hospitalist, Internal Medicine | FL | |
| H O S P I T A L I S T | UT | |
| R H E U M A T O L O G Y | UT | |
| Hospitalist, Internal Medicine | FL |
Reviews
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