Individual provider Active NPI

James H. Stevens Jr., MD

  • Radiation Oncology Physician
  • Fort Walton Beach, FL
National Provider Identifier
1467447565
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME0068163 Issued in FL
Practice address
1026 Mar Walt Dr
Ft Walton Beach, FL 32547-6645
Phone
(850) 863-5294
Fax
(850) 864-1648
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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 ME0068163 FL Primary

Addresses

Primary practice location

1026 Mar Walt Dr
Ft Walton Beach, FL 32547-6645

Mailing address

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

Other identifiers 14

IdentifierTypeStateIssuer
377888600MedicaidFL
1179761OtherFLWELLCARE
009913035OtherALAL. MCAID PSO PROVIDER #
118454 (CRO)MedicaidAL
16-01523OtherFLUTD. HLTHCR. PROVIDER #
009913045OtherALAL. MCAID FWB PROVIDER #
212959OtherFLAVMED
009948615OtherALAL. MCAID SRB PROVIDER #
118469 (DSF)MedicaidAL
8870766-006OtherFLCIGNA PROVIDER NUMBER
009913055OtherALAL. MCAID CRO PROV. #
118458 (FWB)MedicaidAL
5120028OtherFLAETNA PROVIDER NUMBER
118471 (SRB)MedicaidAL

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
I20100217000226 FL Practitioner - Radiation Oncology 5092859876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesiscare USA of Florida LLCGroup PAC ID 9830082882, 172 clinicians

Practice addresses (Care Compare)

1026 Mar Walt Dr
Fort Walton Beach, FL 32547-6645
Phone (850) 863-5294

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0068163FLMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesiscare USA of Florida LLC CurrentSince May 22, 2001 Accepting new patients
Genesiscare USA of Florida LLC Radiation Oncology CurrentSince May 22, 2001 Accepting new patients
Oncology & Hematology Associates of West Broward, P.a. PastSince Jan 7, 2024 Accepting new patients
South Florida Oncology and Hematology Consultants LLC Past Accepting new patients

Locations

425 Nursing Home Dr
Arcadia, FL 34266
Phone (863) 494-9991

1419 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 772-3202

601 Redstone Ave W
Crestview, FL 32536
Phone (239) 432-8500

2160 Colonial Blvd
Fort Myers, FL 33907

2234 Colonial Blvd
Fort Myers, FL 33907
Phone (239) 931-7212

1026 Mar Walt Dr
Fort Walton Beach, FL 32547
Phone (850) 863-5294

3031 Carters Mill Rd
Marianna, FL 32446
Phone (850) 526-2101

1670 N University Dr
Ste A
Pompano Beach, FL 33071
Phone (954) 227-6747

6879 US Highway 98 W
Santa Rosa Beach, FL 32459
Phone (850) 502-1363

3210 Fruitville Rd
Sarasota, FL 34237
Phone (941) 364-8887

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 5

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1467447565",
    "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": "1026 MAR WALT DR",
            "city": "FT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-863-5294",
            "fax_number": "850-864-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JAMES",
        "middle_name": "H.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME0068163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377888600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "1179761",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL. MCAID PSO PROVIDER #",
            "identifier": "009913035",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118454 (CRO)",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTD. HLTHCR. PROVIDER #",
            "identifier": "16-01523",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL. MCAID FWB PROVIDER #",
            "identifier": "009913045",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "212959",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL. MCAID SRB PROVIDER #",
            "identifier": "009948615",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118469 (DSF)",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "8870766-006",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL. MCAID CRO PROV. #",
            "identifier": "009913055",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118458 (FWB)",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "5120028",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118471 (SRB)",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.