NPIMap

Individual provider Active NPI

Billy Pitapong Vanasupa, D.O.

  • Urology Physician
  • Saint Augustine, FL
National Provider Identifier
1689774507
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
OS14893 Issued in FL
Practice address
240 Southpark Cir E
Saint Augustine, FL 32086-5137
Phone
(904) 824-1450
Fax
(386) 239-8530
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X OS14893 FL Primary

Addresses

Primary practice location

240 Southpark Cir E
Saint Augustine, FL 32086-5137

Mailing address

12109 County Road 103
Oxford, FL 34484-2951
Phone (352) 205-8981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100706000339 WA Practitioner - Urology 1850422981 Reassigns benefits to 1 organization
I20180725001231 FL Practitioner - Urology 1850422981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Urology Institute LLCGroup PAC ID 2163653585, 152 clinicians

Practice addresses (Care Compare)

240 Southpark Cir E
Saint Augustine, FL 32086-5137
Phone (904) 824-1450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.09 of 100Reported as group
Promoting interoperability
100
Improvement activities
40
Cost
80.3

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology Institute, LLC Urology CurrentSince Jul 1, 2018 Accepting new patients
Capital Medical Center Specialty Physicians, LLC Urology CurrentSince Feb 1, 2013 Accepting new patients
Northwest Urology Clinic Inc Urology Current Accepting new patients
Advanced Urology Institute, LLC Urology CurrentSince Jul 1, 2018 Accepting new patients
Advanced Urology Institute LLC Urology Past Accepting new patients

Locations

609 W Highland Blvd
Inverness, FL 34452
Phone (352) 726-9707

1035 Piper Blvd
Naples, FL 34110
Phone (239) 333-3200

506 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 427-9554

12109 County Road 103
Oxford, FL 34484
Phone (352) 205-8981

240 Southpark Cir E
St Augustine, FL 32086
Phone (904) 824-1450

113 Whitehall Dr
St Augustine, FL 32086
Phone (904) 824-1450

326 S Stillaguamish Ave
Ste 1
Arlington, WA 98223
Phone (360) 474-0207

1311 E Division St
Mount Vernon, WA 98274
Phone (360) 424-7991

412 Black Hills Ln SW
Ste C
Olympia, WA 98502
Phone (360) 352-2909

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc41222_advuroswflorida
  • Direct secure messaging: bvanasupa744194@direct.shands.ufl.edu

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 7

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1689774507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12109 COUNTY ROAD 103",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842951",
            "telephone_number": "352-205-8981",
            "fax_number": "352-391-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 SOUTHPARK CIR E",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865137",
            "telephone_number": "904-824-1450",
            "fax_number": "386-239-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANASUPA",
        "first_name": "BILLY",
        "middle_name": "PITAPONG",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "OS14893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augustine, FL

Sources for this page

Verify at the official NPI Registry.