Active NPI
Nicholas Tyler Champion, M.D.
- Surgical Oncology Physician
- Tampa, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Oncology Physician
- License
- ME158384
- Practice address
- 12902 Usf Magnolia Dr
Tampa, FL 33612-9416 - Phone
- (813) 745-7365
- Fax
- (813) 449-8618
- NPI assigned
- Apr 27, 2017
- Last updated
- Aug 22, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Oncology Physician | 2086X0206X | ME158384 | FL | Primary |
Addresses
Primary practice location
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Mailing address
PO Box 198441
Atlanta, GA 30384-8441
Phone (813) 745-7365
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Surgical Oncology
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 41 |
| Melanoma (skin cancer) excision | 18 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesiscare USA of Florida LLC | Surgery | Current | Accepting new patients |
| H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc | Surgical Oncology | Current | Accepting new patients |
| Genesiscare USA of Florida LLC | Current | Accepting new patients | |
| Genesiscare USA of Florida LLC | Past | Accepting new patients |
Locations
730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119
18308 Murdock Cir
Unit 105
Pt Charlotte, FL 33948
Phone (941) 743-4150
713 E Marion Ave
Ste 135
Punta Gorda, FL 33950
Phone (941) 205-2370
3210 Fruitville Rd
Sarasota, FL 34237
Phone (941) 364-8887
12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (888) 663-3488
195 Center Rd
Ste B
Venice, FL 34285
Phone (941) 492-6227
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Moffitt Medical Group
- Hematology & Oncology Physician
- Tampa, FL
- NPI 1306833595
Surgical Oncology
-
dba David Schwartzwald, MD: Urology Care Specialists
- Urology Physician
- Boca Raton, FL
- NPI 1649093709
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba HCA Florida Fawcett Hospital
- General Acute Care Hospital
- Port Charlotte, FL
- NPI 1417901406
-
- Special Hospital
- Tampa, FL
- NPI 1780653618
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755820800000",
"number": "1659806644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 198441",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303848441",
"telephone_number": "813-745-7365",
"fax_number": "813-449-8618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12902 USF MAGNOLIA DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336129416",
"telephone_number": "813-745-7365",
"fax_number": "813-449-8618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPION",
"first_name": "NICHOLAS",
"middle_name": "TYLER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-27",
"last_updated": "2025-08-22",
"certification_date": "2025-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "FL",
"license": "ME158384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; 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.