Individual provider Active NPI

Kelly E Lafave, MD

  • Radiation Oncology Physician
  • Winter Park, FL
National Provider Identifier
1376745612
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME106904 Issued in FL
Practice address
483 N Semoran Blvd Ste 107
Winter Park, FL 32792-3800
Phone
(407) 539-0722
Fax
(407) 539-0723
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X ME106904 FL Primary

Addresses

Primary practice location

483 N Semoran Blvd Ste 107
Winter Park, FL 32792-3800

Mailing address

483 N Semoran Blvd Ste 107
Winter Park, FL 32792-3800
Phone (407) 539-0722

Other practice location 1

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone (386) 425-4210

Other identifiers 2

IdentifierTypeStateIssuer
DJ631ZOtherFLMEDICARE ID
0022468MedicaidFL

Other names 1

  • Kelly Allison Evans Former name

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
I20100820000805 FL Practitioner - Radiation Oncology 0840324240 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Michigan State University College of Human Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Oncology Tavares LLCGroup PAC ID 9436469319, 3 clinicians
Florida Radiation Oncology PartnersGroup PAC ID 0547556185, 2 clinicians

Practice addresses (Care Compare)

2010 Nightingale LN
Tavares, FL 32778-4361
Phone (352) 742-3045

483 N Semoran Blvd
Winter Park, FL 32792-3800
Phone (407) 539-0722

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc CurrentSince Feb 9, 2016 Accepting new patients
Florida Oncology Tavares, LLC Radiation Oncology CurrentSince Jul 18, 2015 Accepting new patients
Florida Radiation Oncology Partners Radiation Oncology CurrentSince Jul 1, 2016 Accepting new patients
Heartland Oncology Partners, LLC Radiation Oncology Past Accepting new patients

Locations

303 N Clyde Morris Blvd
Fl First
Daytona Beach, FL 32114
Phone (386) 425-6198

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

2010 Nightingale Ln
Tavares, FL 32778
Phone (352) 609-7006

483 N Semoran Blvd
Ste 107
Winter Park, FL 32792
Phone (407) 539-0722

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1376745612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 N SEMORAN BLVD STE 107",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923800",
            "telephone_number": "407-539-0722",
            "fax_number": "407-539-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 N SEMORAN BLVD STE 107",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923800",
            "telephone_number": "407-539-0722",
            "fax_number": "407-539-0723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 N Clyde Morris Blvd",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321142709",
            "country_code": "US",
            "telephone_number": "386-425-4210",
            "fax_number": "386-425-7725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAFAVE",
        "first_name": "KELLY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME106904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "DJ631Z",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0022468",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "EVANS",
            "middle_name": "ALLISON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.