Paul Appleby, M.D.
NPI 1366806242 · Surgery Physician · Sebastian, FL
Enrolled with Medicare as Practitioner - General Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Paul Appleby, M.D. is a Surgery Physician provider in Sebastian, FL (NPI 1366806242).
Provider details
- NPI number
- 1366806242
- Entity type
- Individual
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- ME169386 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
10 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
4 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
270 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, at Least 35 Minutes99232 | 119 | $74 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 59 | $119 |
| Initial Hospital Care With Straightforward Or Low-Level Medical Decision Making, If Using Time, at Least 55 Minutes99222 | 47 | $123 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 | 31 | $160 |
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 14 | $82 |
Typical Medicare-allowed amounts for these services range $74–$160 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 1 distinct drug on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Oxycodone Hcl/Acetaminophenbrand: Oxycodone-Acetaminophen | 11 | 11 |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Practice location
Mailing address
Additional practice locations (3)
- 2222 S Harbor City Blvd Ste 430Melbourne, FL 32901-5591Phone: (321) 344-8746Fax: (321) 339-1932
- 2131 S 17th StWilmington, NC 28401-7407Phone: (910) 343-7000
- 3 Riverside CirRoanoke, VA 24016-4955Phone: (540) 224-5170Fax: (540) 983-8212
Registry dates
- Enumerated
- 2016-04-07
- Last updated
- 2026-04-10
- Certified
- 2026-04-10
Frequently asked questions
- What is Paul Appleby's NPI number?
- Paul Appleby's National Provider Identifier (NPI) is 1366806242, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Paul Appleby's specialty?
- Paul Appleby is listed in the NPPES registry with a primary specialty of Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Paul Appleby located?
- Paul Appleby's practice location on file with NPPES is 14430 US Hightway 1, Sebastian, FL 32958-3289.
- What is Paul Appleby's phone number?
- The practice phone number listed in the NPPES registry for Paul Appleby is (772) 581-8003.
- Does Paul Appleby accept Medicare?
- Paul Appleby is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Paul Appleby's NPI active?
- Yes — Paul Appleby's NPI (1366806242) is active in the NPPES registry as of the last update on 2026-04-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.