Individual provider Active NPI

Imad V El-Jassous, MD

  • Medical Oncology Physician
  • The Villages, FL
National Provider Identifier
1033374301
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
ME100380 Issued in FL
Practice address
1400 N US Highway 441 Ste 924
The Villages, FL 32159-6812
Phone
(352) 633-8319
Fax
(352) 633-8434
NPI assigned
Jul 25, 2008
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X ME100380 FL
Medical Oncology Physician 207RX0202X ME100380 FL Primary

Addresses

Primary practice location

1400 N US Highway 441 Ste 924
The Villages, FL 32159-6812

Mailing address

PO Box 102222
Attn: Credentialing Dept.
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other identifiers 1

IdentifierTypeStateIssuer
000991700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081014000372 FL Practitioner - Hematology/Oncology 3577631837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 US Hwy 441 North Building 92
Florida Cancer Specialists PL
Lady Lake, FL 32159-8975
Phone (352) 787-9448

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME100380FLMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC Hematology CurrentSince Aug 1, 2014 Accepting new patients
Florida Cancer Specialists P L Hematology PastSince Aug 1, 2014 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Hematology Past Accepting new patients

Locations

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

1400 N US Highway 441
Bldg 920
Lady Lake, FL 32159
Phone (352) 787-9448

1600 W Main St
Leesburg, FL 34748
Phone (352) 323-1482

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

4420 Sun N Lake Blvd
Fl Cancer
Sebring, FL 33872
Phone (863) 385-1244

1400 N US Highway 441
Ste 924
The Villages, FL 32159
Phone (352) 633-8319

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: ieljassous566143@direct.shands.ufl.edu

Organizations & group practices 3

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1033374301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "address_2": "ATTN: CREDENTIALING DEPT.",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200",
            "fax_number": "239-278-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N US HIGHWAY 441 STE 924",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596812",
            "telephone_number": "352-633-8319",
            "fax_number": "352-633-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-JASSOUS",
        "first_name": "IMAD",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-25",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "FL",
            "license": "ME100380",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": "ME100380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000991700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.