NPIMap

Individual provider Active NPI

Jefferson Mason Trupp, MD

  • Radiation Oncology Physician
  • Tuscaloosa, AL
National Provider Identifier
1871552638
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
036171122 Issued in IL
Practice address
1410 McFarland Blvd N
Tuscaloosa, AL 35406-2459
Phone
(205) 345-8208
NPI assigned
Mar 21, 2006
Last updated
Jun 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X ME40682 FL
Radiation Oncology Physician 2085R0001X MD.11479 AL
Radiation Oncology Physician 2085R0001X 036171122 IL Primary

Addresses

Primary practice location

1410 McFarland Blvd N
Tuscaloosa, AL 35406-2459

Mailing address

8203 N Lagoon Dr
Panama City, FL 32408-5267
Phone (850) 896-0773

Other practice location 1

2900 S Highway 77
Lynn Haven, FL 32444-5612
Phone (850) 481-1687

Other practice location 2

100 Doctors Dr
Panama City, FL 32405-7608
Phone (850) 896-0773

Other identifiers 2

IdentifierTypeStateIssuer
000014577MedicaidAL
266076800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL, IL, PA4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20100223000820 FL Practitioner - Radiation Oncology 3375577083
I20101209001175 AL Practitioner - Radiation Oncology 3375577083 Reassigns benefits to 1 organization
I20241007002103 IL Practitioner - Radiation Oncology 3375577083 Reassigns benefits to 3 organizations
I20260228000772 PA Practitioner - Radiation Oncology 3375577083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of South Florida College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

1100 Grampian Blvd
Williamsport, PA 17701-1907
Phone (570) 326-8470

1410 McFarland Blvd N
Tuscaloosa, AL 35406-2209
Phone (205) 345-8208

221 NE Glen Oak Ave
Peoria, IL 61636-0001

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.11479ALMDRadiation Oncology Physician
036171122ILMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services CurrentSince Mar 1, 2026 Accepting new patients
Carle Health Medical Group Multi-Specialty CurrentSince Dec 30, 2025 Accepting new patients
Methodist Medical Center of Illinois Multi-Specialty CurrentSince Sep 1, 2024 Accepting new patients
Southeast Physician Network, P.C. Multi-Specialty CurrentSince Dec 2, 2024 Accepting new patients
Southeast Physician Network, P.C. Multi-Specialty CurrentSince Dec 2, 2024 Accepting new patients
Susquehanna Physician Services Multi-Specialty CurrentSince Mar 1, 2026 Accepting new patients
Methodist Medical Center of Illinois Multi-Specialty CurrentSince Sep 1, 2024 Accepting new patients
Aoa Gulf Coast Partners LP Multi-Specialty Past Accepting new patients
American Professional Associates LLC Multi-Specialty Past Accepting new patients

Locations

1410 McFarland Blvd N
Tuscaloosa, AL 35406
Phone (205) 345-8208

171 Carraway Dr
Winfield, AL 35594
Phone (205) 487-4405

120 NE Glen Oak Ave
Peoria, IL 61603
Phone (309) 672-3158

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

815 Main St
Ste A1
Peoria, IL 61602

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

1100 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8005

Networks

  • bcbs alabama network 01H0
  • bcbs alabama network 01E0
  • bcbs alabama network 01A0
  • bcbs alabama network 01B0
  • bcbs alabama network 01G0

Interoperability endpoints

  • Direct secure messaging: jtrupp81887@directinfirmaryhealth.org
  • Direct secure messaging: jtruppmd427468@carlehiedirect.net

Organizations & group practices 10

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 9

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1871552638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8203 N LAGOON DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324085267",
            "telephone_number": "850-896-0773",
            "fax_number": "850-234-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 MCFARLAND BLVD N",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062459",
            "telephone_number": "205-345-8208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 S Highway 77",
            "address_purpose": "LOCATION",
            "city": "Lynn Haven",
            "state": "FL",
            "postal_code": "324445612",
            "country_code": "US",
            "telephone_number": "850-481-1687",
            "fax_number": "850-640-0761",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Doctors Dr",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324057608",
            "country_code": "US",
            "telephone_number": "850-896-0773",
            "fax_number": "850-234-9272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUPP",
        "first_name": "JEFFERSON",
        "middle_name": "MASON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME40682",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "AL",
            "license": "MD.11479",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036171122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000014577",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266076800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.