NPIMap

Organization Active NPI

21St Century Oncology LLC

Doing business as Boris V Klopukh MD

  • Urology Physician
  • Sunny Isles Beach, FL
National Provider Identifier
1326416017
Registry record updated Jul 12, 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
Boris V Klopukh MD
Practice address
17070 Collins Ave
Suite 257
Sunny Isles Beach, FL 33160-3635
Phone
(305) 534-4747
Fax
(305) 937-7726
NPI assigned
Sep 11, 2015
Last updated
Jul 12, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
21ST CENTURY ONCOLOGY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 12, 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) 931-7277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

17070 Collins Ave
Suite 257
Sunny Isles Beach, FL 33160-3635

Mailing address

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

Other names 1

  • Boris V Klopukh MD 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
Tax ID family
21St Century Oncology LLC72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Locations

78 SW 13th Ave
Ste 200
Miami, FL 33135
Phone (305) 642-6966

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562889600000",
    "number": "1326416017",
    "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": "17070 COLLINS AVE",
            "address_2": "SUITE 257",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331603635",
            "telephone_number": "305-534-4747",
            "fax_number": "305-937-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "21ST CENTURY ONCOLOGY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "21ST CENTURY ONCOLOGY INC",
        "enumeration_date": "2015-09-11",
        "last_updated": "2019-07-12",
        "status": "A",
        "authorized_official_last_name": "COMMINS",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "239-931-7277"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boris V Klopukh MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boris V Klopukh MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sunny Isles Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.