Treasure Coast Cancer Care Center Inc

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

ME0070221 Issued in FL

Legal business name

TREASURE COAST CANCER CARE CENTER INC

Practice address

1700 SE Hillmoor Dr
Ste 306
Port St Lucie, FL 34952-7539

Phone

(772) 398-6016

Fax

(772) 337-0320

NPI assigned

Sep 13, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Siva P Bellam, M.D

Title

President

Phone

(772) 398-6016

Specialties & licenses 1

Addresses

Other identifiers 5

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Arif Shakoor, M.D.

  • Pulmonary Disease Physician
  • Okeechobee, FL
  • NPI 1114951597
  NPD (past)

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403740800000",
    "number": "1407841810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SE HILLMOOR DR",
            "address_2": "STE 306",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527539",
            "telephone_number": "772-398-6016",
            "fax_number": "772-337-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SE HILLMOOR DR",
            "address_2": "STE 306",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527539",
            "telephone_number": "772-398-6016",
            "fax_number": "772-337-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE COAST CANCER CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2014-06-26",
        "status": "A",
        "authorized_official_last_name": "BELLAM",
        "authorized_official_first_name": "SIVA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-398-6016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": "ME0070221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "31481",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "235170784",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250467700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2967902005",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "830005561",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Milady Travieso
• Sistiva Maureen Travis
• Kevin Micheal Traynor, MD
• Treasure Coast Alf Inc.
• Treasure Coast Anesthesiology, P.a.
• Treasure Coast Cosmetic Surgery Center
• Treasure Coast Counseling Center Inc
• Treasure Coast Diagnostics LLC
• Treasure Coast Gi LLC
• Treasure Coast Health (Healthy Results)

• Medical Oncology Physician in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Medical Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.