MOFFITT MEDICAL GROUP – Hematology & Oncology Physician, NPI 1306833595
Hematology & Oncology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MOFFITT MEDICAL GROUP
2590 Healing Way Ste 200
Wesley Chapel, FL 335435497
Phone: (813) 745-4673
Type: Location
10920 McKinley Dr
Tampa, FL 336126471
Phone: (813) 745-4673
Type: Location
2590 Healing Way Ste 100
Wesley Chapel, FL 335435496
Phone: (813) 745-4673
Type: Location
H. Lee Moffitt Cancer Center, 12902, USF Magnolia Drive, Tampa, Hillsborough County, Florida, 33612, United States
TAMPA, FL 336129416
Phone: (813) 745-4673
Type: Location
10901 McKinley Dr
Tampa, FL 336126455
Phone: (813) 745-4673
Type: Location
4101 Jim Walter Blvd
Tampa, FL 336075775
Phone: (813) 745-4673
Type: Location
PO BOX 198441
ATLANTA, GA 303848441
Phone: (866) 761-5658
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2026-01-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-09-30 (983 days ago).
Enrollment records
5
Earliest due date
2023-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20031204000575 | O | Clinic/Group Practice | FL | 2023-09-30 |
| O20210722002102 | O | Clinic/Group Practice | TX | 2026-07-31 |
| O20240315000929 | O | Clinic/Group Practice | AZ | TBD |
| O20240417004338 | O | Clinic/Group Practice | NC | TBD |
| O20260113003230 | O | Clinic/Group Practice | HI | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33543)
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