Individual provider Active NPI

Arthur Cortland Taliaferro, MD

  • Otolaryngology Physician
  • St Augustine, FL
National Provider Identifier
1497859904
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME0066602 Issued in FL
Practice address
3 San Bartola Dr
St Augustine, FL 32086-5767
Phone
(904) 823-8823
Fax
(904) 808-8587
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X ME66602 FL
Otolaryngology Physician 207Y00000X ME0066602 FL Primary

Addresses

Primary practice location

3 San Bartola Dr
St Augustine, FL 32086-5767

Mailing address

15280 NW 79TH CT Ste 200
Miami Lakes, FL 33016-5873
Phone (305) 558-3724

Other identifiers 2

IdentifierTypeStateIssuer
040010602OtherFLRR MEDICARE
377005200MedicaidFL

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
I20050914000094 FL Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 6204869019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of South Florida College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida ENT Associates IncGroup PAC ID 4587556923, 156 clinicians

Practice addresses (Care Compare)

3 San Bartola Dr
St Augustine, FL 32086-5767
Phone (904) 823-8823

Hospital & facility affiliations

  • Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision356
Removal of skin lesions23
Removal of skin cancer829
Skin biopsy57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0066602FLMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida ENT Associates, Inc. Otolaryngology CurrentSince Sep 29, 2023 Accepting new patients
N.F.L. Center for Oto-HNS Facial Plastic Surgery P.a. Otolaryngology CurrentSince Jan 20, 2005 Accepting new patients

Locations

302 W Central Ave
Lake Wales, FL 33853
Phone (863) 421-4558

15280 NW 79th Ct
Ste 200
Miami Lakes, FL 33016

3 San Bartola Dr
St Augustine, FL 32086
Phone (904) 823-8823

160 E Lake Howard Dr
Winter Haven, FL 33881
Phone (863) 299-1251

Interoperability endpoints

  • Direct secure messaging: ataliaferro744264@direct.shands.ufl.edu

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 and National Provider Directory roles.

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1497859904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15280 NW 79TH CT STE 200",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165873",
            "telephone_number": "305-558-3724",
            "fax_number": "786-907-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SAN BARTOLA DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865767",
            "telephone_number": "904-823-8823",
            "fax_number": "904-808-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALIAFERRO",
        "first_name": "ARTHUR",
        "middle_name": "CORTLAND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "FL",
            "license": "ME66602",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME0066602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "040010602",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377005200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.