Individual provider Active NPI

Dudley Atkin Baringer, M.D.

  • Family Medicine Physician
  • St Augustine, FL
National Provider Identifier
1851463731
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0040283 Issued in FL
Practice address
120 Health Park Blvd
Suite 1
St Augustine, FL 32086-3701
Phone
(904) 823-3401
Fax
(904) 829-8649
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0040283 FL Primary

Addresses

Primary practice location

120 Health Park Blvd
Suite 1
St Augustine, FL 32086-3701

Mailing address

120 Health Park Blvd
Suite 1
St Augustine, FL 32086-3701
Phone (904) 823-3401

Other identifiers 1

IdentifierTypeStateIssuer
20054OtherFLOTHER

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
I20100427000619 FL Practitioner - Family Practice 2466466107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crescent Beach Care, LLCGroup PAC ID 5991945289, 5 clinicians

Practice addresses (Care Compare)

6573 A1A
St Augustine, FL 32080-7504
Phone (904) 342-7363

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0040283FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crescent Beach Care LLC Family Medicine CurrentSince Dec 21, 2021 Accepting new patients

Locations

975 S Ponce de Leon Blvd
St Augustine, FL 32084
Phone (352) 694-6331

6573 A1A S
St Augustine, FL 32080
Phone (904) 325-5322

Organizations & group practices 1

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 6

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1851463731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HEALTH PARK BLVD",
            "address_2": "SUITE 1",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863701",
            "telephone_number": "904-823-3401",
            "fax_number": "904-829-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HEALTH PARK BLVD",
            "address_2": "SUITE 1",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863701",
            "telephone_number": "904-823-3401",
            "fax_number": "904-829-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARINGER",
        "first_name": "DUDLEY",
        "middle_name": "ATKIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0040283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "20054",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.