Active NPI
NCCC of Volusia LLC
- Nephrology Physician
- New Smyrna Beach, FL
National Provider Identifier
1700650264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- Legal business name
- NCCC OF VOLUSIA LLC
- Practice address
- 1055 N Dixie Fwy Ste 1
New Smyrna Beach, FL 32168-6200 - Phone
- (386) 423-0505
- NPI assigned
- Nov 14, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rajesh Ailani, MD
- Title
- Authorized Official
- Phone
- (386) 416-0238
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | |||
| Nephrology Physician | 207RN0300X | Primary |
Addresses
Primary practice location
1055 N Dixie Fwy Ste 1
New Smyrna Beach, FL 32168-6200
Mailing address
1055 N Dixie Fwy Ste 1
New Smyrna Beach, FL 32168-6200
Phone (386) 423-0505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240123002435 | FL | Part B Supplier - Clinic/Group Practice | 0042662249 |
Receives reassigned benefits from 1 practitioner Practice locations: New Smyrna Beach, FL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nephrology Physician
- New Smyrna Beach, FL
- NPI 1932425865
Critical Care Medicine, FL
-
- Pulmonary Disease Physician
- New Smyrna Beach, FL
- NPI 1649277880
Critical Care Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699920000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1699920000000",
"number": "1700650264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 N DIXIE FWY STE 1",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321686200",
"telephone_number": "386-423-0505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N DIXIE FWY STE 1",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321686200",
"telephone_number": "386-423-0505"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NCCC OF VOLUSIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-11-14",
"last_updated": "2023-11-14",
"certification_date": "2023-11-14",
"status": "A",
"authorized_official_last_name": "AILANI",
"authorized_official_first_name": "RAJESH",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "386-416-0238",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Critical Care Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Smyrna Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.