DR. TIMOTHY R STAPLETON MD
NPI 1609836402
Orthopaedic Surgery in Macon, GA

Q: What is Timothy Stapleton's NPI number?

The NPI number for Timothy Stapleton is 1609836402. It was assigned to this individual provider in the NPPES registry on March 24, 2006.

Q: What is Timothy Stapleton's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Timothy Stapleton was last updated on October 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.

Active since March 24, 2006PECOS EnrolledAccepts Medicare Assignment

69.72/100

CMS Quality Rating

3708 NORTHSIDE DR, MACON, GA 31210(478) 745-4206(478) 254-5463 Get Directions Write a Review

NPPES record last updated: October 22, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 24, 2023, Feb 26, 2019 (2 updates tracked since 2019).

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About Dr. Timothy R Stapleton Md NPPES

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

DR. TIMOTHY R STAPLETON MD (NPI 1609836402) is an individual orthopaedic surgery provider in Macon, Georgia, licensed in Georgia (36295) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Atrium Health Navicent The Medical Center, and is a graduate of Mercer University School Of Medicine (1987).

NPPES Registry Identity

NPI1609836402

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. TIMOTHY R STAPLETONCredential: MD

Location Address3708 NORTHSIDE DRMacon, GA 31210-2404

Mailing Address3708 Northside DrMacon, GA 31210-2404 · (478) 745-4206 · Fax (478) 254-5463

Phone(478) 745-4206

Fax(478) 254-5463

Sole ProprietorNo

Medical School CMSMercer University School Of MedicineGraduated 1987

Enumeration DateMarch 24, 2006

Last NPPES UpdateOctober 22, 20252 updates tracked since enumeration

NPPES CertifiedOctober 22, 2025

✔ NPI 1609836402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in GA · 36295

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Also ListedOrthopaedic Surgery · Sports MedicineTaxonomy 207XX0005X · License 36295 (GA)

3708 NORTHSIDE DR, Macon, GA 31210

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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

Dr. Timothy R Stapleton Md 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 ID9931185436

PECOS Enrollment IDI20101013000738

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 19

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.

251 services191 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

173 services104 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

139 services86 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

81 services78 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

66 services58 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

64 services51 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

41 services39 patients

Mri scan of arm joint without contrast 73221

An MRI scan of the arm joint is a non-invasive imaging procedure that uses magnetic fields and radio waves to create detailed images of the structures within your arm joint. No contrast dye is used in this process. It helps to diagnose or monitor conditions like arthritis, injuries, or infections.

39 services37 patients

Ct scan of arm without contrast 73200

A CT scan of the arm without contrast is a non-invasive imaging test. It uses X-ray technology to capture detailed images of your arm's structures. It doesn't involve any contrasting dye, hence, minimal preparation is required. It helps in diagnosing injuries or conditions affecting the arm.

34 services32 patients

Mri scan of leg joint without contrast 73721

An MRI scan of your leg joint is a non-invasive procedure that uses magnetic fields and radio waves to create detailed images of the structures within your leg. This helps doctors diagnose or monitor conditions without using contrast dye.

29 services29 patients

Prosthetic repair of shoulder joint, total shoulder 23472

Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.

27 services27 patients

Needle measurement of electrical activity in arm or leg muscles, complete study 95886

This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.

25 services23 patients

Partial removal of collar bone 23120

Partial removal of the collar bone, also known as a clavicle resection, is a procedure performed to reduce pain and improve range of motion in the shoulder. It involves removing a small portion of the clavicle to alleviate pressure on surrounding structures.

23 services23 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

22 services22 patients

Injection, methylprednisolone acetate, 80 mg J1040

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

22 services18 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

17 services17 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

14 services13 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

14 services14 patients

Aspiration and/or injection of fluid from large joint 20610

13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Atrium Health Navicent The Medical Center

Acute Care Hospitals · Macon, GA

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110107

Location777 Hemlock StreetMacon, GA 31201 · Bibb County

Emergency services Birthing friendly

Coliseum Medical Centers, LLC, Dba

Acute Care Hospitals · Macon, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110164

Location350 Hospital DriveMacon, GA 31217 · Bibb County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31210 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$66.89 typical visit price

range $16.68 – $133.24

Typical copayment $16.72 (range $4.17 – $33.31)

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.

69.72/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

38.88

Promoting Interoperability

Improvement Activities

Cost

69.36

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report

66%479 patients4/55-star benchmark: 87%

Controlling High Blood Pressure

35%57 patients2/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

98%1,451 patients4/55-star benchmark: 100%

e-Prescribing

97%474 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

0%457 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

23%962 patients1/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

0%1,316 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 5% · 864 patients

5%864 patients

Provide Patients Electronic Access to Their Health Information

68%491 patients3/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 494 patients

Patients totalRate: 20% · 494 patients

20%494 patients2/55-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 2

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

Knee orthosis, elastic with joints, prefabricated, off-the-shelf L1812

DME-Orthotic Devices · category DF011N

1 supplier11 claims12 services$59.32 avg. paid by Medicare

Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf L3670

DME-Orthotic Devices · category DF000N

1 supplier24 claims24 services$95.92 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 20

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

DR. WALDO EMERSON FLOYD III MD

Orthopaedic Surgery (Hand Surgery)