NPIMap

Organization Active NPI

Cancer Care Centers of Brevard Inc

  • Specialist
  • Sebastian, FL
National Provider Identifier
1013176940
Registry record updated Nov 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CANCER CARE CENTERS OF BREVARD INC
Practice address
13050 US Highway 1
Sebastian, FL 32958-3733
Phone
(321) 952-0898
Fax
(321) 952-6296
NPI assigned
Jun 5, 2008
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Silas J Charles, MDNPI 1508862491
Title
President
Phone
(321) 952-0898

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040122000315 FL Part B Supplier - Clinic/Group Practice 3274435102 Receives reassigned benefits from 24 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Melbourne, FL; Sebastian, FL; Rockledge, FL; Palm Bay, FL; Melbourne, FL; Cocoa Beach, FL; Merritt Island, FL

National Provider Directory

National Provider Directory
Tax ID family
Cancer Care Centers of Brevard Inc (8 organizations share this tax ID)

Locations

2290 W Eau Gallie Blvd
Ste 202
Melbourne, FL 32935
Phone (321) 254-4776

6450 N Wickham Rd
Ste 105
Melbourne, FL 32940
Phone (321) 253-2266

10 San Filippo Dr SE
Palm Bay, FL 32909
Phone (321) 752-4811

1038 Harvin Way
Ste 120
Rockledge, FL 32955
Phone (321) 636-2111

830 Century Medical Dr
Titusville, FL 32796

1541 S Wickham Rd
West Melbourne, FL 32904
Phone (321) 725-8300

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

NPPES NPI Registry

Primary practice location

13050 US Highway 1
Sebastian, FL 32958-3733

Mailing address

PO Box 534595
Atlanta, GA 30353-4595
Phone (321) 952-0898

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
CL7578OtherFLRR MEDICARE
372996605MedicaidFL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 24, 2009.

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259020800000",
    "number": "1013176940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 534595",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303534595",
            "telephone_number": "321-952-0898",
            "fax_number": "321-952-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13050 US HIGHWAY 1",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583733",
            "telephone_number": "321-952-0898",
            "fax_number": "321-952-6296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CARE CENTERS OF BREVARD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2009-11-24",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "SILAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-952-0898",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CL7578",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372996605",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.