NPIMap

Organization Active NPI

Missouri Cancer Associates LLC

  • Oncology Clinic/Center
  • Columbia, MO
National Provider Identifier
1215947338
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology Clinic/CenterTaxonomy code 261QX0200X
Legal business name
MISSOURI CANCER ASSOCIATES LLC
Practice address
1705 E Broadway
Suite 100
Columbia, MO 65201-5852
Phone
(573) 874-7800
Fax
(573) 443-3627
NPI assigned
Aug 9, 2006
Last updated
Feb 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Authorized official

Name
Dr. Andrew Iliff, MDNPI 1851654818
Title
President
Phone
(573) 874-7800

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Clinic/Center 261QX0200X NU Primary

Addresses

Primary practice location

1705 E Broadway
Suite 100
Columbia, MO 65201-5852

Mailing address

1705 E Broadway Ste 100
Columbia, MO 65201-7167
Phone (573) 874-7800

Other identifiers 2

IdentifierTypeStateIssuer
501811509MedicaidMO
509696605MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040228000384 MO Part B Supplier - Clinic/Group Practice 8729975305 Receives reassigned benefits from 27 practitioners
Practice locations: Sedalia, MO; Columbia, MO; Osage Beach, MO; Mexico, MO; Marshall, MO; Macon, MO; Hannibal, MO; Kirksville, MO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

2372 Paysphere Cir
Chicago, IL 60674

1705 E Broadway
Ste 100
Columbia, MO 65201
Phone (573) 874-7800

1705 E Broadway
Ste 230
Columbia, MO 65201

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1215947338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 E BROADWAY STE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017167",
            "telephone_number": "573-874-7800",
            "fax_number": "573-443-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 E BROADWAY",
            "address_2": "SUITE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015852",
            "telephone_number": "573-874-7800",
            "fax_number": "573-443-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI CANCER ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "ILIFF",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-874-7800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QX0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501811509",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509696605",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.