Individual provider Active NPI

Marilyn Staton

  • Physician Assistant
  • Homosassa, FL
National Provider Identifier
1497153274
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108371 Issued in FL
Practice address
53 Douglas St Apt 34
Homosassa, FL 34446-3958
Phone
(989) 400-7541
NPI assigned
Dec 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X FK0578229 FL
Physician Assistant 363A00000X PA9108371 FL Primary

Addresses

Primary practice location

53 Douglas St Apt 34
Homosassa, FL 34446-3958

Mailing address

22 Golfview Dr
Homosassa, FL 34446-4219
Phone (989) 400-7541

Other identifiers 1

IdentifierTypeStateIssuer
015400500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150923000946 FL Practitioner - Physician Assistant 7911214937 Reassigns benefits to 2 organizations
I20241008001224 TX Practitioner - Physician Assistant 7911214937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

923 Senior Circle
Macy, NE 68039-4018

Hospital & facility affiliations

  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127

Merit-based Incentive Payment System (MIPS)

Final score
77.07 of 100Reported as group
Quality
73.06
Improvement activities
40
Cost
69.92

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
FK0578229FLMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Associates L L C CurrentSince Aug 12, 2025 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Sep 25, 2024 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Sep 25, 2024 Accepting new patients
Bikkasani Ram Hellstern and Chandrupatla Mdpa CurrentSince Dec 11, 2023 Accepting new patients

Locations

6410 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-2450

3633 Little Rd
Ste 101
Trinity, FL 34655
Phone (372) 375-2222

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

1801 Chukka Hina
Durant, OK 74701
Phone (580) 920-2100

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DJCABD
  • Direct secure messaging: marilyn.staton.p1@direct.cdsdp.nextgenshare.com
  • Direct secure messaging: mstaton24323@choctawnation.direct-ci.com

Organizations & group practices 4

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 1

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": "1418169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1497153274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 GOLFVIEW DR",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344464219",
            "telephone_number": "989-400-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 DOUGLAS ST APT 34",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344463958",
            "telephone_number": "989-400-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATON",
        "first_name": "MARILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-10",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "FK0578229",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015400500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homosassa, FL

Sources for this page

Verify at the official NPI Registry.