Individual provider Active NPI

Randy Kahn, M.D.

  • Radiation Oncology Physician
  • Sun City Center, FL
National Provider Identifier
1083682496
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME57679 Issued in FL
Practice address
4031 Upper Creek Dr
Sun City Center, FL 33573-6819
Phone
(813) 633-2733
Fax
(813) 634-8606
NPI assigned
Mar 10, 2006
Last updated
Jul 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X ME57679 FL Primary

Addresses

Primary practice location

4031 Upper Creek Dr
Sun City Center, FL 33573-6819

Mailing address

4031 Upper Creek Dr
Sun City Center, FL 33573-6819

Other identifiers 1

IdentifierTypeStateIssuer
57542900MedicaidFL

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
I20100709000103 FL Practitioner - Radiation Oncology 2567445018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
New York Medical College, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Bay Radiation Oncology PAGroup PAC ID 2769465210, 4 clinicians
NMC LLCGroup PAC ID 2668537689, 5 clinicians

Practice addresses (Care Compare)

4031 Upper Creek Dr
Sun City Center, FL 33573-6819
Phone (813) 633-2733

621 Lumsden Professional CT
Brandon, FL 33511-5996
Phone (813) 657-4004

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Tampa Bay Radiation Oncology, PA Radiation Oncology CurrentSince Jan 7, 2003 Accepting new patients
NMC LLC Radiation Oncology CurrentSince Jan 1, 2009 Accepting new patients

Locations

621 Lumsden Professional Ct
Brandon, FL 33511
Phone (813) 644-4910

621 Lumsden Professional Ct
#C
Brandon, FL 33511
Phone (813) 657-4004

4031 Upper Creek Dr
Sun City Ctr, FL 33573
Phone (813) 633-2733

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://fhir-myrecord.cerner.com/r4/_equjXi-I6k5_iN9ulQyh3xNMVDgQ7-w/
  • Direct secure messaging: rkahn8109@direct.tgh.org

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 5

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1083682496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4031 UPPER CREEK DR",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335736819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4031 UPPER CREEK DR",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335736819",
            "telephone_number": "813-633-2733",
            "fax_number": "813-634-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHN",
        "first_name": "RANDY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME57679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57542900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City Center, FL

Sources for this page

Verify at the official NPI Registry.