Individual provider Active NPI

Nilesh V Dubal, MD

  • Radiation Oncology Physician
  • Melbourne, FL
National Provider Identifier
1447254776
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME159596 Issued in FL
Practice address
1130 Hickory St Ste a
Melbourne, FL 32901-1973
Phone
(321) 409-1956
Fax
(321) 409-1253
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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 ME159596 FL Primary

Addresses

Primary practice location

1130 Hickory St Ste a
Melbourne, FL 32901-1973

Mailing address

3300 S Fiske Blvd Ste 605
Rockledge, FL 32955-4306
Phone (321) 409-1956

Other practice location 1

8725 N Wickham Rd Ste 103
Melbourne, FL 32940-2240
Phone (321) 409-1956

Other identifiers 3

IdentifierTypeStateIssuer
117331000MedicaidFL
QK112OtherFLMEDICARE HF
3889572MedicaidTN

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
I20230315000010 FL Practitioner - Radiation Oncology 4688646680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Wake Forest University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians

Practice addresses (Care Compare)

1130 Hickory St
Melbourne, FL 32901-1973
Phone (321) 725-4500

Hospital & facility affiliations

  • Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
  • Viera Hospital Hospital, Melbourne, FL, CCN 100315
  • Palm Bay Hospital Hospital, Palm Bay, FL, CCN 100316
  • Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME159596FLMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The West Clinic P.C. CurrentSince Apr 19, 2014 Accepting new patients
Health First Medical Group, LLC CurrentSince May 1, 2023 Accepting new patients
Health First Medical Group, LLC CurrentSince May 1, 2023 Accepting new patients
Mid South Radiation Oncology Center, LLC Radiation Oncology Past Accepting new patients
Memphis Radiological, PC Past Accepting new patients

Locations

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

1130 Hickory St
Melbourne, FL 32901
Phone (321) 409-1956

1130 Hickory St
Ste A
Melbourne, FL 32901
Phone (321) 409-1956

3300 S Fiske Blvd
Ste 605
Rockledge, FL 32955

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

8725 N Wickham Rd
Ste 103
Viera, FL 32940
Phone (321) 253-4673

1381 S Germantown Rd
Germantown, TN 38138
Phone (901) 516-0583

7945 Wolf River Blvd
Memphis, TN 38138
Phone (901) 448-7000

1588 Union Ave
Memphis, TN 38104
Phone (901) 276-2410

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

7714 Poplar Ave
Ste 200
Memphis, TN 38138
Phone (901) 322-9080

Interoperability endpoints

  • Direct secure messaging: ndubal27505@epicdirect.hf.org

Organizations & group practices 5

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 7

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1447254776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD STE 605",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-409-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 HICKORY ST STE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011973",
            "telephone_number": "321-409-1956",
            "fax_number": "321-409-1253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8725 N Wickham Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329402240",
            "country_code": "US",
            "telephone_number": "321-409-1956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBAL",
        "first_name": "NILESH",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME159596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117331000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HF",
            "identifier": "QK112",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3889572",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.