Jeffrey Gray Brabham, MD
Individual provider Active NPI Radiation Oncology Physician · Tavares, FL
NPI 1639336233 · NPPES record last updated Jun 4, 2019
Key facts
- NPI
- 1639336233
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Radiation Oncology Physician 2085R0001X
- License
- ME103670 (FL)
- Practice address
- 2010 Nightingale Lane
Tavares, FL 32778-4361 - Phone
- (352) 742-3045
- Fax
- (352) 742-3169
- NPI assigned
- May 21, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Radiation Oncology
- Education
- University of Florida College of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Florida Oncology Tavares LLC
Practice addresses (Care Compare)
2010 Nightingale LN
Tavares, FL 32778-4361
Phone (352) 742-3045
Hospital & facility affiliations
- Adventhealth Waterman
Merit-based Incentive Payment System (MIPS)
- Final score
- 72.36 of 100
- Quality
- 55.49
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 52.38
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090820000150 | FL | Practitioner - Radiation Oncology | 3274687694 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME103670 | FL | MD | Radiation Oncology Physician |
Practice roles (4 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Halifax Healthcare Systems Inc | Current |
Accepting new patients | |
| Alliant Dermatology PA | Current |
Accepting new patients | |
| Florida Oncology Tavares, LLC | Radiation Oncology | Current |
Accepting new patients |
| Heartland Oncology Partners, LLC | Radiation Oncology | Past | Accepting new patients |
Locations
303 N Clyde Morris Blvd
Fl First
Daytona Beach, FL 32114
Phone (386) 425-6198
303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285
2010 Nightingale Ln
Tavares, FL 32778
Phone (352) 609-7006
1050 Old Camp Rd
Ste 150
The Villages, FL 32162
Phone (352) 399-7295
8620A E County Road 466
The Villages, FL 32162
Phone (352) 399-7295
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- jbrabham562516@direct.shands.ufl.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | ME103670 | FL | Yes |
Addresses
Primary practice location
2010 Nightingale Lane
Tavares, FL 32778-4361
Mailing address
2010 Nightingale Lane
Tavares, FL 32778-4361
Phone (352) 742-3045
Other practice location 1
303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone (386) 425-4210
Other providers in Tavares, FL
- Richard T Bosshardt
- Brittney Bowen
- Charles D. Bowers
- Elsie H Bowman
- Brian Lee Boyd
- Alecia Brantum
- Roger J Bricault
- Bridge of Life Support Services
- Nadine Bridges
- Brighter Dreams Corp.
All providers in Tavares, FL · Radiation Oncology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.