Active NPI
Benjamin Ryan Staley
- Physician Assistant
- Wilmington, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-15849
- Practice address
- 1415 Physicians Dr
Wilmington, NC 28401-7338 - Phone
- (910) 662-9500
- NPI assigned
- Oct 27, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | |||
| Physician Assistant | 363A00000X | 0010-15849 | NC | Primary |
Addresses
Primary practice location
1415 Physicians Dr
Wilmington, NC 28401-7338
Mailing address
PO Box 936857
Atlanta, GA 31193-6857
Other practice location 1
2553 31st St Apt E104
Denver, CO 80216-4824
Phone (240) 446-3700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251223000708 | NC | Practitioner - Physician Assistant | 4789058405 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Novant Health Medical Group Coastal Region LLC
Practice addresses (Care Compare)
1415 Physicians Dr
Wilmington, NC 28401-7338
Phone (910) 662-9500
Hospital & facility affiliations
- University of MD Baltimore Washington Medical Center
- Novant Health New Hanover Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-15849 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group Coastal Region, LLC | Current | Accepting new patients | |
| NMG Health Services LLC | Current | Accepting new patients | |
| New Hanover Medical Group PA | Past | Accepting new patients |
Locations
800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164
1415 Physicians Dr
Wilmington, NC 28401
Phone (910) 251-3766
1500 Physicians Dr
Wilmington, NC 28401
Phone (910) 736-6332
Interoperability endpoints
- bstaley1016760@direct.umm.edu
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.
-
- Cardiovascular Disease Physician
- Wilmington, NC
- NPI 1649865791
NC
-
- Cardiovascular Disease Physician
- Wilmington, NC
- NPI 1982280285
-
- Maternal & Fetal Medicine Physician
- Bolivia, NC
- NPI 1558242495
-
- Family Medicine Physician
- Wilmington, NC
- NPI 1992751374
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wilmington, NC
- NPI 1376139139
Hospital
-
- General Acute Care Hospital
- Glen Burnie, MD
- NPI 1124016696
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766707200000",
"number": "1972220168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 936857",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311936857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 PHYSICIANS DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017338",
"telephone_number": "910-662-9500"
}
],
"practiceLocations": [
{
"address_1": "2553 31st St Apt E104",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802164824",
"country_code": "US",
"telephone_number": "240-446-3700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STALEY",
"first_name": "BENJAMIN",
"middle_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-27",
"last_updated": "2025-12-26",
"certification_date": "2025-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-15849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.