Individual provider Active NPI

Jamie A Cesaretti, MD

  • Radiation Oncology Physician
  • Winter Park, FL
National Provider Identifier
1669444725
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME102354 Issued in FL
Practice address
1561 W Fairbanks Ave
Suite 100
Winter Park, FL 32789-4678
Phone
(407) 478-4920
Fax
(407) 478-4921
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X ME102354 FL Primary
Radiation Oncology Physician 2085R0001X 2233361 NY

Addresses

Primary practice location

1561 W Fairbanks Ave
Suite 100
Winter Park, FL 32789-4678

Mailing address

7017 A C Skinner Parkway
Jacksonville, FL 32256
Phone (904) 520-6800

Other identifiers 4

IdentifierTypeStateIssuer
000285800MedicaidFL
318866OtherFLAVMED
53300OtherFLBCBS OF FL
02637534MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080922000380 FL Practitioner - Radiation Oncology 3173572625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
State University of New York at Stony Brook, School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7017 A C Skinner Pkwy
Jacksonville, FL 32256-6932
Phone (904) 483-2310

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME102354FLMDRadiation Oncology Physician
2233361NYMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Physician Specialists LLC Radiation Oncology Current Accepting new patients
Florida Physician Specialists LLC Radiation Oncology CurrentSince Jan 1, 2013 Accepting new patients
Memorial Southside Cancer Center LLC Past Accepting new patients
North Florida Cancer Center Lake City LLC Radiation Oncology Past Accepting new patients
North Florida Cancer Center Live Oak LLC Radiation Oncology Past Accepting new patients
Integrated Community Oncology Network LLC Radiation Oncology Past Accepting new patients

Locations

710 Lomax St
Ste 1
Jacksonville, FL 32204
Phone (904) 483-2310

7017 A C Skinner Pkwy
Jacksonville, FL 32256
Phone (904) 520-6800

5742 Booth Rd
Ste B
Jacksonville, FL 32207
Phone (904) 309-8680

710 Lomax St
Jacksonville, FL 32204
Phone (904) 355-6584

1375 Roberts Dr
Ste 100
Jax Bch, FL 32250
Phone (904) 242-0166

2161 Kingsley Ave
Ste 100
Orange Park, FL 32073
Phone (904) 276-2303

1895 Kingsley Ave
Ste 600
Orange Park, FL 32073
Phone (904) 276-2303

600 Zeagler Dr
Ste 2
Palatka, FL 32177
Phone (386) 325-8140

300 Health Park Blvd
Ste 1008
St Augustine, FL 32086
Phone (904) 264-8418

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 6

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1669444725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7017 A C SKINNER PARKWAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-520-6800",
            "fax_number": "904-520-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 W FAIRBANKS AVE",
            "address_2": "SUITE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894678",
            "telephone_number": "407-478-4920",
            "fax_number": "407-478-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CESARETTI",
        "first_name": "JAMIE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME102354",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "2233361",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000285800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "318866",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "53300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02637534",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.