Nishitha Reddy Thumallapally, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

ME159539 Issued in FL

Practice address

121 Whitehall Dr
St Augustine, FL 32086-5266

Phone

(904) 825-4500

Fax

(907) 825-3672

NPI assigned

May 7, 2014

Reactivated

Sep 23, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Hematology/Oncology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cancer Specialists LLCGroup PAC ID 9133377948, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
• AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nthumallapally744038@direct.shands.ufl.edu

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.

• Cancer Specialists, LLC

  • Hematology & Oncology Physician
  • Jacksonville, FL
  • NPI 1528323268
  Medicare reassignment Care Compare group NPD
• Cancer Specialists, LLC

  • Pharmacy
  • Jacksonville, FL
  • NPI 1851656607
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Flagler Hospital Inc

  • General Acute Care Hospital
  • St Augustine, FL
  • NPI 1144211020
  Care Compare affiliation
• Flagler Hospital, Inc.

  • Urgent Care Clinic/Center
  • Saint Augustine, FL
  • NPI 1447527965

  Hospital

  Care Compare affiliation
• Memorial Hospital Flagler Inc

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  Care Compare affiliation

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1548670946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 A C SKINNER PKWY STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566932",
            "telephone_number": "904-363-2113",
            "fax_number": "904-363-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WHITEHALL DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865266",
            "telephone_number": "904-825-4500",
            "fax_number": "907-825-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUMALLAPALLY",
        "first_name": "NISHITHA",
        "middle_name": "REDDY",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "deactivation_date": "2014-12-09",
        "reactivation_date": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME159539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118147900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "6UOLE",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "QU962",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Melissa Thorpe, OT
• Robert R. Thousand III, D.D.S.
• Robert Roy Thousand Jr., D.D.S.
• Thrive Chiropractic & Yoga LLC
• Thrive Therapy Group
• Joan Tibaldi, LCSW, BCD
• Michael Brian Till, M.D.
• Timmothy Nelson Tillotson, LCSW
• Timestampsnfl LLC
• Catherine Timm Fulkerson

• Hematology & Oncology Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Hematology & Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.