Cancer Care of North Florida & Urology Medical of North Florida – Radiation Oncology Physician, NPI 1396132213
Radiation Oncology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Cancer Care of North Florida & Urology Medical of North Florida
289 SW STONEGATE TER
SUITE 103
LAKE CITY, FL 320243456
Phone: (386) 755-1655
Fax: (386) 628-9231
Type: Mailing
4520 W US Highway 90
Lake City, FL 320558341
Phone: (386) 755-0601
Type: Location
289 SW STONEGATE TER STE 103
LAKE CITY, FL 320243457
Phone: (386) 755-1655
Fax: (386) 628-9231
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: 2024-03-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-07-31 (1043 days ago).
Enrollment records
2
Earliest due date
2023-07-31
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 |
|---|---|---|---|---|
| O20150715000887 | O | Clinic/Group Practice | FL | 2023-07-31 |
| O20240326003969 | O | Clinic/Group Practice | DC | 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 32024)
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