Individual provider Active NPI

Nathan Cecava, MD

  • Diagnostic Radiology Physician
  • Lackland AFB, TX
National Provider Identifier
1235194168
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01056531A Issued in IN
Practice address
1100 Wilford Hall Loop
Lackland AFB, TX 78236-5638
Phone
(210) 292-5290
NPI assigned
Apr 20, 2006
Last updated
Apr 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 01056531A IN
Diagnostic Radiology Physician 2085R0202X 01056531A IN Primary

Addresses

Primary practice location

1100 Wilford Hall Loop
Lackland AFB, TX 78236-5638

Mailing address

1100 Wilford Hall Loop BLDG 4554
Lackland AFB, TX 78236-5638
Phone (210) 292-6225

Other practice location 1

2200 Berquist Drive, Suite1
Wilford Hall Ambulatory Surgical Center, 59 MDW/GME
JBSA Lackland AFB, TX 78236-9908
Phone (210) 292-5290

Other practice location 2

2200 Berquist Drive, Suite1
Wilford Hall Ambulatory Surgical Center, 59 MDW/GME
JBSA Lackland AFB, TX 78236-9908
Phone (210) 292-5290

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
I20220210001844 FL Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 5991937260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
University of New Mexico School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Florida Radiology Associates PAGroup PAC ID 0941224612, 33 clinicians

Practice addresses (Care Compare)

1450 Berryhill Rd
Milton, FL 32570-4028
Phone (850) 626-7762

2190 Hwy 85 N
Niceville, FL 32578-1045
Phone (850) 678-4131

6002 Berryhill Rd
Milton, FL 32570-5062
Phone (850) 626-9942

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01056531AINMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Florida Radiology Associates PA Diagnostic Radiology CurrentSince Jan 1, 2022 Accepting new patients
North Star MCD, LLC Current Accepting new patients
Radiology Associates of Southwest Louisiana Diagnostic Radiology Past Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

160 Twin Springs Way
Defuniak Springs, FL 32435
Phone (850) 389-6955

6478 Highway 90
Unit D
Milton, FL 32570

12230 Coit Rd
Ste 100
Dallas, TX 75251
Phone (214) 252-7020

Organizations & group practices 4

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1235194168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-5290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Berquist Drive, Suite1",
            "address_2": "Wilford Hall Ambulatory Surgical Center, 59 MDW/GME",
            "address_purpose": "LOCATION",
            "city": "JBSA Lackland AFB",
            "state": "TX",
            "postal_code": "782369908",
            "country_code": "US",
            "telephone_number": "210-292-5290",
            "fax_number": "210-292-3946",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Berquist Drive, Suite1",
            "address_2": "Wilford Hall Ambulatory Surgical Center, 59 MDW/GME",
            "address_purpose": "LOCATION",
            "city": "JBSA Lackland AFB",
            "state": "TX",
            "postal_code": "782369908",
            "country_code": "US",
            "telephone_number": "210-292-5290",
            "fax_number": "210-292-3946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CECAVA",
        "first_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01056531A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01056531A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland AFB, TX

Sources for this page

Verify at the official NPI Registry.