Individual provider Active NPI

Sheilaine R Mabanta, M.D.

  • Radiation Oncology Physician
  • Staples, MN
National Provider Identifier
1619925484
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
65060 Issued in MN
Practice address
49725 County 83
Staples, MN 56479-5280
Phone
(218) 894-1515
Fax
(218) 894-8767
NPI assigned
May 4, 2006
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X ME74201 FL
Radiation Oncology Physician 2085R0001X P6999 TX
Radiation Oncology Physician 2085R0001X 65060 MN Primary
Specialist 174400000X ME74201 FL

Addresses

Primary practice location

49725 County 83
Staples, MN 56479-5280

Mailing address

49725 County 83
Staples, MN 56479-5280
Phone (218) 894-1515

Other identifiers 3

IdentifierTypeStateIssuer
328624701MedicaidTX
259085900MedicaidFL
295100YS65OtherTXMEDICARE ID

Other names 1

  • Miss Sheilaine Rodrigo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101018001077 FL Practitioner - Radiation Oncology 6103019500 Reassigns benefits to 2 organizations
I20190409001591 MN Practitioner - Radiation Oncology 6103019500 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Tulane University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakewood Health SystemGroup PAC ID 1052229671, shared by 15 NPIs, 107 clinicians
Florida Hospital Medical Group IncGroup PAC ID 0042383200, 329 clinicians

Practice addresses (Care Compare)

49725 County
Staples, MN 56479-5280
Phone (218) 894-1515

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-5600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65060MNMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Radiation Oncology CurrentSince Sep 13, 2021 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Apr 1, 2019 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Apr 1, 2019 Accepting new patients
Lakewood Health System Current Accepting new patients
Lakewood Health System CurrentSince Oct 2, 2025 Accepting new patients
Florida Radiology Imaging at Lake Mary, LLC CurrentSince Sep 13, 2021 Accepting new patients
Lakewood Health System CurrentSince Oct 2, 2025 Accepting new patients
Florida Hospital Physician Group Inc PastSince Sep 23, 2021 Accepting new patients
Norman H. Anderson, MD, PA Radiation Oncology PastSince Jul 1, 2023 Accepting new patients

Locations

900 Winderley Pl
Ste 1100
Maitland, FL 32751
Phone (407) 200-1606

235 E Princeton St
Ste 100
Orlando, FL 32804
Phone (407) 303-1414

2501 N Orange Ave
Ste 182
Orlando, FL 32804
Phone (407) 303-2030

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

712 S Cascade St
Fergus Falls, MN 56537

49725 County 83
Staples, MN 56479
Phone (218) 894-1033

960 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/
  • Direct secure messaging: s.mabanta@choicecancercare.direct.varian.com
  • Direct secure messaging: smabanta618737@adventhealth.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1619925484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABANTA",
        "first_name": "SHEILAINE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME74201",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "P6999",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MN",
            "license": "65060",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME74201",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "328624701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259085900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "295100YS65",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHEILAINE",
            "last_name": "RODRIGO",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staples, MN

Sources for this page

Verify at the official NPI Registry.