Individual provider Active NPI

Byron Layne Stapleton, DO

  • Surgery Physician
  • St Augustine, FL
National Provider Identifier
1053610923
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OS16229 Issued in FL
Practice address
300 Health Park Blvd Ste 5002
St Augustine, FL 32086
Phone
(904) 819-5861
Fax
(904) 819-5862
NPI assigned
Mar 17, 2011
Last updated
Oct 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 34.012166 OH
Surgery Physician 208600000X OS16229 FL Primary

Addresses

Primary practice location

300 Health Park Blvd Ste 5002
St Augustine, FL 32086

Mailing address

PO Box 3266
St Augustine, FL 32085-3266
Phone (904) 819-4602

Other practice location 1

630 W Main St
Wilmington, OH 45177-2170
Phone (937) 283-2520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191007003278 FL Practitioner - General Surgery 9133342264 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villages Regional Hospital Physician Services LLCGroup PAC ID 0244688893, 198 clinicians

Practice addresses (Care Compare)

10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone (352) 255-3615

300 Health Park Blvd
Suite 5002
Saint Augustine, FL 32086-3705
Phone (904) 819-5861

351 Town Plaza Ave
Ponte Vedra, FL 32081-5179

400 Health Park Blvd
St Augustine, FL 32086-5784
Phone (904) 823-1447

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.78 of 100Reported as apm
Quality
77.66
Promoting interoperability
70.54
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS16229FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flagler Professional Health Care Services, Inc. Current Accepting new patients
Flagler Professional Health Care Services Inc. Surgery CurrentSince Sep 1, 2019 Accepting new patients
Flagler Professional Health Care Services, Inc. CurrentSince Sep 1, 2019 Accepting new patients
Villages Regional Hospital Physician Services LLC Surgery CurrentSince Jun 7, 2025 Accepting new patients
Flagler Professional Health Care Services, Inc. CurrentSince Jul 23, 2024 Accepting new patients

Locations

351 Town Plaza Ave
Ste 201
Ponte Vedra, FL 32081
Phone (888) 481-2135

120 Palencia Village Dr
Ste 107
Saint Augustine, FL 32095
Phone (904) 819-3200

300 Health Park Blvd
St Augustine, FL 32086
Phone (904) 460-9191

300 Health Park Blvd
Ste 5002
St Augustine, FL 32086
Phone (904) 819-5861

10435 SE 170th Pl
Summerfield, FL 34491
Phone (352) 245-7788

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: bstapleton744016@direct.shands.ufl.edu

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1053610923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3266",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320853266",
            "telephone_number": "904-819-4602",
            "fax_number": "904-819-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEALTH PARK BLVD STE 5002",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32086",
            "telephone_number": "904-819-5861",
            "fax_number": "904-819-5862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 W Main St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "OH",
            "postal_code": "451772170",
            "country_code": "US",
            "telephone_number": "937-283-2520",
            "fax_number": "937-283-2526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAPLETON",
        "first_name": "BYRON",
        "middle_name": "LAYNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-17",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34.012166",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS16229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.