Individual provider Active NPI

Joshua Brian Dault, MD

  • Radiation Oncology Physician
  • Tallahassee, FL
National Provider Identifier
1154775724
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME147896 Issued in FL
Practice address
2003 Centre Pointe Blvd
Tallahassee, FL 32308-4893
Phone
(850) 878-2273
Fax
(850) 671-5900
NPI assigned
Apr 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 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 ME147896 FL Primary

Addresses

Primary practice location

2003 Centre Pointe Blvd
Tallahassee, FL 32308-4893

Mailing address

2003 Centre Pointe Blvd
Tallahassee, FL 32308-4893
Phone (850) 878-2273

Other practice location 1

1250 E Marshall St
Box 980509
Richmond, VA 23298-5051
Phone (804) 828-8786

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
I20210902003325 FL Practitioner - Radiation Oncology 5890089460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Florida State University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahassee Memorial Healthcare IncGroup PAC ID 6103724778, shared by 11 NPIs, 498 clinicians
North Florida Cancer Center Tallahassee LLCGroup PAC ID 6800837048, 2 clinicians

Practice addresses (Care Compare)

1775 One Healing PL
Tallahassee, FL 32308-4600
Phone (850) 431-5360

2003 Centre Pointe Blvd
Tallahassee, FL 32308-4893
Phone (850) 878-2273

Hospital & facility affiliations

  • Tallahassee Memorial Healthcare Hospital, Tallahassee, FL, CCN 100135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME147896FLMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Cancer Center Tallahassee LLC Radiation Oncology CurrentSince Aug 1, 2021 Accepting new patients

Locations

2003 Centre Pointe Blvd
Tallahassee, FL 32308
Phone (850) 758-7822

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.

Hospital & facility affiliations 1

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": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1154775724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 CENTRE POINTE BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084893",
            "telephone_number": "850-878-2273",
            "fax_number": "850-671-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 CENTRE POINTE BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084893",
            "telephone_number": "850-878-2273",
            "fax_number": "850-671-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St",
            "address_2": "Box 980509",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985051",
            "country_code": "US",
            "telephone_number": "804-828-8786",
            "fax_number": "804-828-5466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAULT",
        "first_name": "JOSHUA",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME147896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.