NPIMap

Organization Active NPI

PCCC of Volusia LLC

  • Pulmonary Disease Physician
  • New Smyrna Beach, FL
National Provider Identifier
1285685370
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME89115 Issued in FL
Legal business name
PCCC OF VOLUSIA LLC
Practice address
1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201
Phone
(386) 423-0505
Fax
(386) 423-0515
NPI assigned
May 13, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Rajesh K Ailani, MDNPI 1649277880
Title
MD
Phone
(386) 423-0505

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME89115 FL
Pulmonary Disease Physician 207RP1001X ME89115 FL Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X

Addresses

Primary practice location

1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201

Mailing address

1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201
Phone (386) 423-0505

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060802000485 FL Part B Supplier - Clinic/Group Practice 7911910237 Receives reassigned benefits from 25 practitioners
Practice locations: Ormond Beach, FL; Port Orange, FL; Palm Coast, FL; Orange City, FL; New Smyrna Beach, FL; Edgewater, FL; Deland, FL; Daytona Beach, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1092928PCCC of Volusia LLC1055 N Dixie Freeway Ste 1, New Smyrna Beach, FL 32168Certificate of waiverJan 26, 2028

National Provider Directory

National Provider Directory

Locations

575 N Clyde Morris Blvd
Ste B
Daytona Beach, FL 32114
Phone (386) 217-6556

638 W Plymouth Ave
Deland, FL 32720
Phone (386) 279-0006

907 N Stone St
Deland, FL 32720
Phone (386) 423-0505

1055 N Dixie Fwy
Ste C
New Smyrna Beach, FL 32168

802 Sterthaus Dr
Ste C
Ormond Beach, FL 32174
Phone (386) 317-6501

61 Memorial Medical Pkwy
#3
Palm Coast, FL 32164
Phone (386) 671-6333

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71631

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1285685370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N DIXIE FWY",
            "address_2": "SUITE 1",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686201",
            "telephone_number": "386-423-0505",
            "fax_number": "386-423-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N DIXIE FWY",
            "address_2": "SUITE 1",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686201",
            "telephone_number": "386-423-0505",
            "fax_number": "386-423-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCCC OF VOLUSIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "AILANI",
        "authorized_official_first_name": "RAJESH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "386-423-0505",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME89115",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME89115",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.