NPIMap

Individual provider Active NPI

Maureen Claire Holasek, M.D.

  • Radiation Oncology Physician
  • Clermont, FL
National Provider Identifier
1588660658
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME62103 Issued in FL
Practice address
1920 Don Wickham Dr
Ste. 130
Clermont, FL 34711-1918
Phone
(352) 243-9709
Fax
(352) 243-8703
NPI assigned
Jun 23, 2005
Last updated
Jun 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME62103 FL
Radiation Oncology Physician 2085R0001X ME62103 FL Primary

Addresses

Primary practice location

1920 Don Wickham Dr
Ste. 130
Clermont, FL 34711-1918

Mailing address

PO Box 864460
Orlando, FL 32886-0001
Phone (352) 243-9709

Other identifiers 4

IdentifierTypeStateIssuer
P00470573OtherFLRR MEDICARE
15050OtherFLBCBS
212921OtherFLAVMED
370683400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040207000131 FL Practitioner - Radiation Oncology 7517850928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians for Accountable Care LLCGroup PAC ID 4789624826, 2 clinicians

Practice addresses (Care Compare)

922 Rolling Acres Rd
Lady Lake, FL 32159-5036
Phone (352) 326-2224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME62103FLMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Care Centers of Brevard Inc Specialist Past Accepting new patients
Intercommunity Cancer Center - Lady Lake Campus LLC Radiation Oncology Past Accepting new patients
Integrated Community Oncology Network LLC Radiation Oncology Past Accepting new patients
Cancer Care Centers of Brevard Inc Specialist PastSince Jul 31, 2023 Accepting new patients
Vantage Radiation Oncology Associates LLC Radiation Oncology Past Accepting new patients
Physicians for a Community United for Research and Education LLC Radiation Oncology Past Accepting new patients
Physicians for a Community United for Research and Education LLC Radiation Oncology Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1588660658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 864460",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328860001",
            "telephone_number": "352-243-9709",
            "fax_number": "352-243-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 DON WICKHAM DR",
            "address_2": "STE. 130",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111918",
            "telephone_number": "352-243-9709",
            "fax_number": "352-243-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLASEK",
        "first_name": "MAUREEN",
        "middle_name": "CLAIRE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME62103",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME62103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00470573",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "15050",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "212921",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370683400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.