BAYSIDE MEDICAL PRACTICE OF VILANO BEACH LLC
NPI 1760168330
Clinic/Center - Primary Care in St Augustine, FL
About Bayside Medical Practice Of Vilano Beach Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BAYSIDE MEDICAL PRACTICE OF VILANO BEACH LLC (NPI 1760168330) is a healthcare organization registered as a primary care in St Augustine, Florida and active in the NPI registry since June 2023. The organization holds a CLIA Waiver certificate valid through November 13, 2027, maintains a secondary practice location in St Augustine, and lists Tammy Rowland Dye, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bayside Medical Practice Of Vilano Beach Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Bayside Medical Practice Of Vilano Beach LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 10D2293750
Bayside Medical Practice Of Vilano Beach LLC · Saint Augustine, FLFrequently 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 Bayside Medical Practice Of Vilano Beach LLC's NPI number?
The NPI number for Bayside Medical Practice Of Vilano Beach LLC is 1760168330. It was assigned to this organization in the NPPES registry on June 27, 2023.
Where is Bayside Medical Practice Of Vilano Beach LLC located?
Bayside Medical Practice Of Vilano Beach LLC is located at 101 Yacht Club Dr, St Augustine, FL 32084. The listed phone number is (904) 217-4550.
What is Bayside Medical Practice Of Vilano Beach LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Bayside Medical Practice Of Vilano Beach LLC enrolled in Medicare?
Yes. Bayside Medical Practice Of Vilano Beach LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Bayside Medical Practice Of Vilano Beach LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Bayside Medical Practice Of Vilano Beach LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Bayside Medical Practice Of Vilano Beach LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D2293750) is associated with this NPI, valid through November 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Bayside Medical Practice Of Vilano Beach LLC was last updated on September 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Bayside Medical Practice Of Vilano Beach Llc · NPI 1760168330
Primary Care organization in St Augustine, Florida. Organization record, active in the CMS NPPES registry since June 27, 2023.
## Identity
- **NPI:** 1760168330 (Entity type: Organization)
- **Enumerated:** June 27, 2023
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Tammy Dye, PRESIDENT
## Practice location
- **Address:** 101 YACHT CLUB DR, St Augustine, FL 32084-2196
- **Phone:** (904) 217-4550 · **Fax:** (904) 907-2113
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 1, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1760168330) · Data from the CMS NPPES public registry.