NPIMap

Organization Active NPI

21St Century Oncology LLC

Doing business as Southwest Florida Urologic Associates

  • Urology Physician
  • Cape Coral, FL
National Provider Identifier
1225074115
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
21ST CENTURY ONCOLOGY LLC
Doing business as
Southwest Florida Urologic Associates
Practice address
507 Del Prado Blvd S
Cape Coral, FL 33990-2618
Phone
(239) 772-0500
Fax
(239) 772-3076
NPI assigned
Jun 21, 2006
Last updated
Jul 15, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
RADIATION THERAPY SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Authorized official

Name
Kim Commins
Title
Ceo
Phone
(239) 931-7275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

507 Del Prado Blvd S
Cape Coral, FL 33990-2618

Mailing address

2234 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other identifiers 4

IdentifierTypeStateIssuer
060239643MedicaidFL
060239642MedicaidFL
060239641MedicaidFL
060239640MedicaidFL

Other names 1

  • Southwest Florida Urologic Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204000663 FL Part B Supplier - Clinic/Group Practice 9830082882 Receives reassigned benefits from 314 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563148800000",
    "number": "1225074115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902618",
            "telephone_number": "239-772-0500",
            "fax_number": "239-772-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "21ST CENTURY ONCOLOGY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADIATION THERAPY SERVICES INC",
        "enumeration_date": "2006-06-21",
        "last_updated": "2019-07-15",
        "status": "A",
        "authorized_official_last_name": "COMMINS",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "239-931-7275"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060239643",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060239642",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060239641",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060239640",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Florida Urologic Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southwest Florida Urologic Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.