Individual provider Active NPI

Alan Steven Collin, MD

  • Hematology & Oncology Physician
  • Port St Lucie, FL
National Provider Identifier
1003855255
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
0028942 Issued in FL
Practice address
1871 SE Tiffany Ave
Suite 100
Port St Lucie, FL 34952-7585
Phone
(772) 335-5666
Fax
(772) 335-4826
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 0028942 FL Primary

Addresses

Primary practice location

1871 SE Tiffany Ave
Suite 100
Port St Lucie, FL 34952-7585

Mailing address

1871 SE Tiffany Ave
Suite 100
Port St Lucie, FL 34952-7585
Phone (772) 335-5666

Other identifiers 5

IdentifierTypeStateIssuer
039319300MedicaidFL
1003855255OtherNPI
830003201OtherFLRAILROAD MEDICARE
0028942OtherFLFLORIDA LICENSE NUMBER
92812OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0028942FLMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Hematology Oncology PastSince Oct 1, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1003855255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1871 SE TIFFANY AVE",
            "address_2": "SUITE 100",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527585",
            "telephone_number": "772-335-5666",
            "fax_number": "772-335-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1871 SE TIFFANY AVE",
            "address_2": "SUITE 100",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527585",
            "telephone_number": "772-335-5666",
            "fax_number": "772-335-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIN",
        "first_name": "ALAN",
        "middle_name": "STEVEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "0028942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039319300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1003855255",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "830003201",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE NUMBER",
            "identifier": "0028942",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "92812",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.