Individual provider Active NPI

Charles Alan Byron, PAC

  • Physician Assistant
  • Panama City, FL
National Provider Identifier
1376510560
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3642 Issued in FL
Practice address
1900 Harrison Ave
Panama City, FL 32405-4542
Phone
(850) 769-1668
Fax
(850) 785-2123
NPI assigned
Mar 7, 2006
Last updated
May 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA3642 FL Primary

Addresses

Primary practice location

1900 Harrison Ave
Panama City, FL 32405-4542

Mailing address

4120 Deerpoint Lake Dr
Panama City, FL 32409-2164
Phone (850) 769-1668

Other identifiers 1

IdentifierTypeStateIssuer
E5077OtherFLBLUE CROSS

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110401000852 FL Practitioner - Physician Assistant 6800070632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1900 Harrison Ave
Panama City, FL 32405-4542
Phone (850) 769-1668

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.48 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
91.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Bay County, P.a. CurrentSince Jul 8, 2010 Accepting new patients
Dermatology Associates of Bay County, P.a. PastSince Dec 14, 2025 Accepting new patients

Locations

1900 Harrison Ave
Panama City, FL 32405
Phone (850) 769-7546

12216 Panama City Beach Pkwy
Ste D
Panama City Beach, FL 32407
Phone (850) 655-7090

Organizations & group practices 2

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 2

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1376510560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 DEERPOINT LAKE DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324092164",
            "telephone_number": "850-769-1668",
            "fax_number": "850-785-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-769-1668",
            "fax_number": "850-785-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRON",
        "first_name": "CHARLES",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "E5077",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.