1. Home
  2. Directory
  3. Georgia
  4. Monroe
  5. Ophthalmology
  6. NPI Profile

STEPHEN ALTON BAYNHAM M.D., F.A.A.O.
NPI 1225011075
Ophthalmology in Monroe, GA

Active since November 25, 2005PECOS EnrolledAccepts Medicare Assignment
92.32/100
CMS Quality Rating
517 GREAT OAKS DR, STE 101, MONROE, GA 30655(770) 267-4561(770) 267-8061 Get Directions Write a Review

NPPES record last updated: November 2, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Stephen Alton Baynham M.d., F.a.a.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STEPHEN ALTON BAYNHAM M.D., F.A.A.O. (NPI 1225011075) is an individual ophthalmology provider in Monroe, Georgia, licensed in Georgia (048208) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Piedmont Walton Hospital, and is a graduate of Mercer University School Of Medicine (1996).

NPPES Registry Identity

NPI1225011075
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameSTEPHEN ALTON BAYNHAMCredential: M.D., F.A.A.O.
Location Address517 GREAT OAKS DR, STE 101Monroe, GA 30655-8211
Mailing Address517 Great Oaks Dr, Ste 101Monroe, GA 30655-8211 · (770) 267-4561 · Fax (770) 267-8061
Phone(770) 267-4561
Fax(770) 267-8061
Sole ProprietorNo
Medical School CMSMercer University School Of MedicineGraduated 1996
Enumeration DateNovember 25, 2005
Last NPPES UpdateNovember 2, 2007
✔ NPI 1225011075 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in GA · 048208
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
517 GREAT OAKS DR, Monroe, GA 30655
Open in Google Maps ↗

Other Identifiers 2

Medicare PIN18BDFRTGA
Medicare UPINH15746GA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Stephen Alton Baynham M.d., F.a.a.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991891392
PECOS Enrollment IDI20071017000213
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
1,539 services1,129 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
373 services368 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
299 services295 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
178 services178 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
175 services111 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
168 services105 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Piedmont Walton Hospital

Acute Care Hospitals · Monroe, GA
4/5 CMS rating
OwnershipProprietary
CMS Certification Number110046
Location2151 W Spring StreetMonroe, GA 30655 · Walton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30655 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.32/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality84.64
Improvement Activities40

Reported Quality Measures

Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture
Lower rates are better for this measure.
0%510 patients
Breast Cancer Screening
0%1,213 patients1/55-star benchmark: 93%
Cervical Cancer Screening
0%725 patients1/55-star benchmark: 98%
Colorectal Cancer Screening
0%2,217 patients1/55-star benchmark: 88%
Diabetes: Eye Exam
98%905 patients4/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
82%865 patients1/55-star benchmark: 91%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
100%211 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
99%5,551 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
0%2,585 patients1/55-star benchmark: 100%
HIV Screening
0%1,356 patients1/55-star benchmark: 60%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
23%3,495 patients1/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
0%3,548 patients1/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
6%5,486 patients1/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 99% · 1,787 patients
Patients screened: 100% · 1,787 patients
96%153 patients4/55-star benchmark: 100%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
0%536 patients
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
4%862 patients1/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 3% · 2,690 patients
Patients totalRate: 3% · 2,690 patients
0%2,690 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier60 claims60 services$62.38 avg. paid by Medicare
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens V2203
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier67 claims128 services$41.70 avg. paid by Medicare
Bifocal seg width over 28 mm V2219
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier43 claims50 services$36.20 avg. paid by Medicare
U-v lens, per lens V2755
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier69 claims134 services$15.02 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DONNA JENKINS PAUSE NP-C
Nurse Practitioner (Family)
517 GREAT OAKS DR, SUITE 102
MONROE, GA 30655
Walton County (770) 267-6565
LEANN HARDISON ROBERSON PT
Physical Therapist
517 GREAT OAKS DR, SUITE 102
MONROE, GA 30655
Walton County (770) 296-6624
FRANK D MORRIS JR. LCSW
Social Worker (Clinical)
517 GREAT OAKS DR
MONROE, GA 30655
Walton County (770) 267-2035
LESLIE NILSEN
Physical Therapist (Orthopedic)
517 GREAT OAKS DR, SUITE 102
MONROE, GA 30655
Walton County (770) 207-6624
SARAH V MCBEE MD PC
Clinic/Center (Primary Care)
517 GREAT OAKS DR, SUITE 102
MONROE, GA 30655
Walton County (770) 267-6565
MRS. LORI ALLEN SADLER CPNP-PC
Nurse Practitioner (Pediatrics)
517 GREAT OAKS DR, SUITE #103
MONROE, GA 30655
Walton County (770) 207-7916
SARAH V MCBEE MD
Internal Medicine
517 GREAT OAKS DR, SUITE 102
MONROE, GA 30655
Walton County (770) 267-6565
MRS. EMILY RYE FNP
Nurse Practitioner (Family)
517 GREAT OAKS DR
MONROE, GA 30655
Walton County (770) 267-6565

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stephen Baynham's NPI number?

The NPI number for Stephen Baynham is 1225011075. It was assigned to this individual provider in the NPPES registry on November 25, 2005.

Where is Stephen Baynham located?

Stephen Baynham practices at 517 Great Oaks Dr Ste 101, Monroe, GA 30655. The listed phone number is (770) 267-4561.

What is Stephen Baynham's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Stephen Baynham enrolled in Medicare?

Yes. Stephen Baynham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Stephen Baynham accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 5 other insurers list Stephen Baynham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Stephen Baynham affiliated with any hospitals?

According to CMS data, Stephen Baynham is affiliated with Piedmont Walton Hospital.

When was this NPI record last updated?

The NPPES record for Stephen Baynham was last updated on November 2, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.