Individual provider Active NPI

Elizabeth C. Kent, M.D.

  • Medical Oncology Physician
  • Fleming Island, FL
National Provider Identifier
1790756450
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
ME116639 Issued in FL
Practice address
4689 US Highway 17 Ste 2-5
Fleming Island, FL 32003-4831
Phone
(904) 269-6526
Fax
(904) 269-6527
NPI assigned
Jan 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X ME116639 FL
Medical Oncology Physician 207RX0202X ME116639 FL Primary

Addresses

Primary practice location

4689 US Highway 17 Ste 2-5
Fleming Island, FL 32003-4831

Mailing address

PO Box 102222
Attn: Credentialing
Atlanta, GA 30368-2222
Phone (239) 432-8331

Other identifiers 1

IdentifierTypeStateIssuer
009197200MedicaidFL

Other names 1

  • Elizabeth C. Storen Former name

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
I20130725000743 FL Practitioner - Hematology/Oncology 5890767040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Wayne State University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

105 Badger Park Dr
Suite 14
St Johns, FL 32259-1165
Phone (904) 269-6526

2848 Ctr Pointe Dr
FL 1
Fort Myers, FL 33916-9521
Phone (239) 561-9622

2890 Ctr Pointe Dr
Fort Myers, FL 33916-9521

4689 US Hwy 17
Suite 2 5
Fleming Island, FL 32003-4831
Phone (904) 269-6526

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME116639FLMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC Hematology CurrentSince Jun 15, 2017 Accepting new patients
Kansas City Cancer Center, LLC Hematology Past Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Hematology Past Accepting new patients

Locations

4689 US Highway 17
Ste 25
Fleming Island, FL 32003
Phone (904) 269-6526

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

10232 San Jose Blvd
Jacksonville, FL 32257
Phone (904) 292-3700

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

105 Badger Park Dr
Ste 14
St Johns, FL 32259

Organizations & group practices 3

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 5

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1790756450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "address_2": "ATTN: CREDENTIALING",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-432-8331",
            "fax_number": "813-976-7895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4689 US HIGHWAY 17 STE 2-5",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034831",
            "telephone_number": "904-269-6526",
            "fax_number": "904-269-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENT",
        "first_name": "ELIZABETH",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "FL",
            "license": "ME116639",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": "ME116639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009197200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "STOREN",
            "middle_name": "C.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.