1. Home
  2. Directory
  3. Florida
  4. Fernandina Beach
  5. Urology
  6. NPI Profile

BAPTIST UROLOGY, INC.
NPI 1689011710
Urology in Fernandina Beach, FL

Active since May 30, 2013CLIA 10D2098436 · Waiver
1348 S 18TH ST STE 210, FERNANDINA BEACH, FL 32034(904) 277-2003(904) 376-3271 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 11, 2025, Dec 12, 2018, Dec 28, 2017 (3 updates tracked since 2017).

About Baptist Urology, Inc. NPPES

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

BAPTIST UROLOGY, INC. (NPI 1689011710) is a healthcare organization registered as an urology in Fernandina Beach, Florida and active in the NPI registry since May 2013. The organization holds a CLIA Waiver certificate valid through July 6, 2027 and lists Masha Donaldson, Administrator, as its authorized official.

NPPES Registry Identity

NPI1689011710
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameBAPTIST UROLOGY, INC.
Location Address1348 S 18TH ST STE 210Fernandina Beach, FL 32034-4785
Mailing AddressPo Box 746643Atlanta, GA 30374-6643 · (904) 202-2092 · Fax (904) 376-4075
Phone(904) 277-2003
Fax(904) 376-3271
Organization SubpartNo
Authorized OfficialMasha DonaldsonAdministrator · (904) 376-3707
Enumeration DateMay 30, 2013
Last NPPES UpdateJune 11, 20253 updates tracked since enumeration
NPPES CertifiedJune 11, 2025
✔ NPI 1689011710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
1348 S 18TH ST STE 210, Fernandina Beach, FL 32034
Open in Google Maps ↗

Other Identifiers 1

OtherDU3519FL · Railroad Medicare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Baptist Urology, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Baptist Urology, Inc., which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Jessica Bruland, APRN
Nurse Practitioner
NPI 1275144362
1348 S 18TH ST STE 230
Fernandina Beach, FL 32034
(904) 277-2003
✔ PECOS✔ Accepts MedicareSame address
Margeaux Dennis, DO
Urology
NPI 1356831630
1348 S 18TH ST STE 230
Fernandina Beach, FL 32034
(904) 277-2003
✔ PECOS✔ Accepts MedicareSame address
Blaine Kristo, MD
Urology
NPI 1124128822
1348 S 18TH ST STE 230
Fernandina Beach, FL 32034
(904) 277-2003
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2098436

Baptist Urology · Fernandina Beach, FL
Active · expires Jul 6, 2027
CLIA Number10D2098436
Laboratory TypePhysician Office
Certificate Effective DateJuly 7, 2025
Certificate Expiration DateJuly 6, 2027
Laboratory DirectorKenneth Son
Laboratory Phone(904) 277-2003
Laboratory LocationBaptist Urology1348 S 18th St - Ste 230, Fernandina Beach, FL 32034
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Baptist Urology, Inc.'s NPI number?

The NPI number for Baptist Urology, Inc. is 1689011710. It was assigned to this organization in the NPPES registry on May 30, 2013.

Where is Baptist Urology, Inc. located?

Baptist Urology, Inc. is located at 1348 S 18th St Ste 210, Fernandina Beach, FL 32034. The listed phone number is (904) 277-2003.

What is Baptist Urology, Inc.'s specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Baptist Urology, Inc. enrolled in Medicare?

Yes. Baptist Urology, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Baptist Urology, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Baptist Urology, Inc., in Nurse Practitioner and Urology. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Baptist Urology, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2098436) is associated with this NPI, valid through July 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Baptist Urology, Inc. accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Baptist Urology, Inc. 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.

When was this NPI record last updated?

The NPPES record for Baptist Urology, Inc. was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.