Bryan Andrew Stam, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 3453 Issued in FL

Practice address

10915 Baymeadows Rd Ste 110
Jacksonville, FL 32256-9131

Phone

(904) 647-9655

Fax

(904) 647-9611

NPI assigned

Jul 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Couzens Stam Domingo PA

  • Optometrist
  • Jacksonville Beach, FL
  • NPI 1003955568
  Medicare reassignment NPD Authorized official
• DRS. Barrack & Liane,PA

  • Optometrist
  • Jacksonville, FL
  • NPI 1528001708
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1245239581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10915 BAYMEADOWS RD STE 110",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569131",
            "telephone_number": "904-647-9655",
            "fax_number": "904-647-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10915 BAYMEADOWS RD STE 110",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569131",
            "telephone_number": "904-647-9655",
            "fax_number": "904-647-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAM",
        "first_name": "BRYAN",
        "middle_name": "ANDREW",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3453",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "FL",
            "license": "OPC 3453",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620556900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620603400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanika Stallworth, CNA
• Cecelia A Stalnaker-Cauwenberghs, LMHC
• Zachary Winfield Stalnaker, D.C., B.S.B.A.
• Mackenzie Stalter
• Angela Kathleen Stalvey, ARNP-BC
• James A Staman, MD
• Jonathan A Staman, M.D.
• Kelsey Elizabeth Stambaugh, PT
• Natalie M Stamey, PSY D
• Stamper Haven

• Optometrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.