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BRIAN GALEN ANDREW DALTON M.D,
NPI 1801058169
Surgery in Jacksonville, FL

Active since June 27, 2008PECOS EnrolledAccepts Medicare Assignment
79.26/100
CMS Quality Rating
655 W 8TH ST, JACKSONVILLE, FL 32209(904) 383-1015(904) 244-3870 Get Directions Write a Review

NPPES record last updated: August 27, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 27, 2021, Aug 21, 2017, Mar 16, 2016 (3 updates tracked since 2016).

About Brian Galen Andrew Dalton M.d, NPPES

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

BRIAN GALEN ANDREW DALTON M.D, (NPI 1801058169) is an individual surgery provider in Jacksonville, Florida, licensed in Florida (ME126414) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and is a graduate of Medical College Of Georgia School Of Medicine (2008).

NPPES Registry Identity

NPI1801058169
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameBRIAN GALEN ANDREW DALTONCredential: M.D,
Location Address655 W 8TH STJacksonville, FL 32209-6511
Mailing Address11945 San Jose Blvd, Ste 300Jacksonville, FL 32223-1627 · (904) 396-1725 · Fax (904) 396-4893
Phone(904) 383-1015
Fax(904) 244-3870
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2008
Enumeration DateJune 27, 2008
Last NPPES UpdateAugust 27, 20213 updates tracked since enumeration
NPPES CertifiedAugust 27, 2021
✔ NPI 1801058169 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in FL · ME126414✔ Licensed in SC · LL30950✔ Licensed in OH · 35.122372✔ Licensed in PA · MD454268
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
655 W 8TH ST, Jacksonville, FL 32209
Open in Google Maps ↗

Other Identifiers 4

OtherME126414FL · Florida Board Of Medicine
Other57.022483OH · Training Certificate
OtherLL30950SC · South Carolina Board Of Medical Examiner's
OtherMD454268PA · Pennsylvania Medical Board

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Cigna Healthcare, Cigna HealthCare of Florida, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brian Galen Andrew Dalton M.d, 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 ID9335387877
PECOS Enrollment IDI20160728000399
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Brian Dalton reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Florida Jacksonville Physicians Inc
Same address
Diagnostic Radiology
655 W 8TH ST, UFJP RADIOLOGY
Jacksonville, FL 32209
  • Reassigned Medicare billing, Florida enrollment
  • 1,456 clinicians in this Medicare group
NPI 1326208695 (904) 244-3660
North Florida Surgeons, PA
14 mi
Surgery
11945 SAN JOSE BLVD STE 300
Jacksonville, FL 32223
  • Reassigned Medicare billing, Florida enrollment
  • 321 clinicians in this Medicare group
NPI 1912953290 (904) 396-1725

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

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.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
93 services50 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.
66 services66 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
51 services50 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.
31 services30 patients
Repair of groin hernia using an endoscope 49650
This procedure involves the use of an endoscope, a thin tube with a camera, to repair a hernia in the groin area. The surgeon makes small incisions, inserts the endoscope, and uses special tools to fix the hernia. This minimally invasive technique often results in quicker recovery times.
30 services30 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.
30 services30 patients

Hospital Affiliations CMS Care Compare 4

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

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100088
Location800 Prudential DrJacksonville, FL 32207 · Duval County
Emergency services Birthing friendly

Baptist Medical Center Beaches

Acute Care Hospitals · Jacksonville Beach, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100117
Location1350 13th Ave SJacksonville Beach, FL 32250 · Duval County
Emergency services Birthing friendly

Baptist Medical Center - Nassau

Acute Care Hospitals · Fernandina Beach, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100140
Location1250 S 18th StFernandina Beach, FL 32034 · Nassau County
Emergency services

Ascension St Vincent's Southside

Acute Care Hospitals · Jacksonville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100307
Location4201 Belfort RdJacksonville, FL 32216 · Duval County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32209 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

79.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.47
Promoting Interoperability96
Improvement Activities40

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. MATTHEW DUWAIN WARRICK M.D.
Anesthesiology
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-4195
DR. MARYAM OOJA ABUBAKAR MD, MPH
Pediatrics (Neonatal-Perinatal Medicine)
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-3508
CHRISTOPHER FULLER PT, DPT
Physical Therapist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-0411
WILLIAM RENFRO PHARM. D.
Pharmacist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-2179
CAM-TU NGUYEN PHARMD
Pharmacist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (352) 682-4355
LOGAN SMITH PHARMD
Pharmacist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (478) 387-5570
HANNAH BISOGLIO
Student in an Organized Health Care Education/Training Program
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-0411
DR. CARMELA MONTEIRO MD
Pathology (Anatomic Pathology)
655 W 8TH ST, UFJP PATHOLOGY DEPT
JACKSONVILLE, FL 32209
Duval County (904) 244-4699

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 Brian Dalton's NPI number?

The NPI number for Brian Dalton is 1801058169. It was assigned to this individual provider in the NPPES registry on June 27, 2008.

Where is Brian Dalton located?

Brian Dalton practices at 655 W 8th St, Jacksonville, FL 32209. The listed phone number is (904) 383-1015.

What is Brian Dalton's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Brian Dalton enrolled in Medicare?

Yes. Brian Dalton 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.

Which organizations bill Medicare for Brian Dalton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brian Dalton reassigns Medicare benefits to 2 organizations: University Of Florida Jacksonville Physicians Inc (Jacksonville, FL) and North Florida Surgeons, PA (Jacksonville, FL). Each 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 Brian Dalton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Brian Dalton accept?

Health plans from AvMed, Cigna HealthCare of Florida, Inc., Cigna Healthcare, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 1 other insurer list Brian Dalton 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 Brian Dalton affiliated with any hospitals?

According to CMS data, Brian Dalton is affiliated with Baptist Health Medical Center - Jacksonville, Baptist Medical Center Beaches, Baptist Medical Center - Nassau and Ascension St Vincent's Southside.

When was this NPI record last updated?

The NPPES record for Brian Dalton was last updated on August 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.