NPIMap

Individual provider Active NPI

Justin Myles Stark, D.O.

  • Internal Medicine Physician
  • Orange Park, FL
National Provider Identifier
1093087579
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS19751 Issued in FL
Practice address
2300 Park Ave Ste 200
Orange Park, FL 32073-5574
Phone
(904) 269-2900
Fax
(904) 269-1140
NPI assigned
Jan 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X OS19751 FL
Internal Medicine Physician 207R00000X OS19751 FL Primary

Addresses

Primary practice location

2300 Park Ave Ste 200
Orange Park, FL 32073-5574

Mailing address

2300 Park Ave Ste 200
Orange Park, FL 32073-5574
Phone (904) 269-2900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230711002230 FL Practitioner - Internal Medicine 8729217336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

1801 Barrs St
Suite 120
Jacksonville, FL 32204-4738
Phone (904) 308-2006

2300 Park Ave
Suite 200
Orange Park, FL 32073-5571
Phone (904) 269-2900

900 Beach Blvd
Jacksonville Beach, FL 32250-4368
Phone (904) 249-0335

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
  • Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Ascension St Vincent'S Clay County Hospital, Middleburg, FL, CCN 100321
  • Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS19751FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Baptist Primary Care Inc Family Medicine Current Accepting new patients
Baptist Primary Care Inc. Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Sep 26, 2025 Accepting new patients
St Vincents Ambulatory Care Inc Internal Medicine CurrentSince Sep 26, 2025 Accepting new patients

Locations

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

900 Beach Blvd
Jax Bch, FL 32250
Phone (904) 249-0335

2300 Park Ave
Ste 200
Orange Park, FL 32073
Phone (904) 269-1075

1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1093087579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 PARK AVE STE 200",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735574",
            "telephone_number": "904-269-2900",
            "fax_number": "904-269-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 PARK AVE STE 200",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735574",
            "telephone_number": "904-269-2900",
            "fax_number": "904-269-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "JUSTIN",
        "middle_name": "MYLES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-31",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS19751",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS19751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.