Individual provider Active NPI

Jimmy Caudell, MD

  • Radiation Oncology Physician
  • Jackson, MS
National Provider Identifier
1376753889
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
20557 Issued in MS
Practice address
2500 N State St
Department of Radiation Oncology
Jackson, MS 39216-4500
Phone
(601) 984-2550
Fax
(601) 815-6876
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 26887 AL
Radiation Oncology Physician 2085R0001X 20557 MS Primary

Addresses

Primary practice location

2500 N State St
Department of Radiation Oncology
Jackson, MS 39216-4500

Mailing address

131 Plantation Dr
Madison, MS 39110-8553
Phone (601) 984-2550

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
I20111110000697 FL Practitioner - Radiation Oncology 6002985694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Texas Medical School at Houston, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88 of 100Reported as group
Quality
74.04
Promoting interoperability
100
Improvement activities
40
Cost
70.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20557MSMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc CurrentSince Oct 1, 2011 Accepting new patients

Locations

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720

Interoperability endpoints

  • Direct secure messaging: jimmy.caudell@direct.moffitt.org

Organizations & group practices 1

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 1

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1376753889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 PLANTATION DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108553",
            "telephone_number": "601-984-2550",
            "fax_number": "601-815-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "DEPARTMENT OF RADIATION ONCOLOGY",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-2550",
            "fax_number": "601-815-6876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUDELL",
        "first_name": "JIMMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "AL",
            "license": "26887",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MS",
            "license": "20557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.