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ACKERMAN CANCER CENTER, PA
NPI 1912786963
Urology in St Augustine, FL

Active since September 27, 2023
533 W TWINCOURT TRL STE 701, ST AUGUSTINE, FL 32095(904) 490-7400 Get Directions Write a Review

NPPES record last updated: January 22, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Ackerman Cancer Center, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ACKERMAN CANCER CENTER, PA (NPI 1912786963) is a healthcare organization registered as an urology in St Augustine, Florida and active in the NPI registry since September 2023. The organization lists Scot Ackerman, Owner, as its authorized official.

NPPES Registry Identity

NPI1912786963
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameACKERMAN CANCER CENTER, PA
Location Address533 W TWINCOURT TRL STE 701St Augustine, FL 32095-8884
Mailing Address10881 San Jose BlvdJacksonville, FL 32223-6612 · (908) 880-5522
Phone(904) 490-7400
Organization SubpartNo
Authorized OfficialScot AckermanOwner · (904) 880-5522
Enumeration DateSeptember 27, 2023
Last NPPES UpdateJanuary 22, 2024
NPPES CertifiedJanuary 22, 2024
✔ NPI 1912786963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Also ListedRadiology · Radiation OncologyTaxonomy 2085R0001X
533 W TWINCOURT TRL STE 701, St Augustine, FL 32095
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ackerman Cancer Center, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

19

Medicare enrollment records show 19 clinicians reassign Medicare billing to Ackerman Cancer Center, PA, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians by Medicare Specialty 5

Nurse Practitioner7
Radiation Oncology5
Urology4
Diagnostic Radiology2
Hematology/Oncology1

Clinicians, nearest first (19)

Suada Muminovic
Nurse Practitioner
NPI 1487463501
533 W TWINCOURT TRL STE AND702
Saint Augustine, FL 32095
(904) 990-0028
✔ PECOSSame address
Josephine Belanger, ARNP
Nurse Practitioner
NPI 1962959700
10881 SAN JOSE BLVD
Jacksonville, FL 32223
(904) 260-3022
✔ PECOS17 mi
Katrina Evans
Nurse Practitioner
NPI 1639555964
10881 SAN JOSE BLVD
Jacksonville, FL 32223
(904) 880-5522
✔ PECOS17 mi
Paul Ossi, M.D.
Radiation Oncology
NPI 1972508299
10881 SAN JOSE BLVD
Jacksonville, FL 32223
(904) 387-9525
✔ PECOS✔ Accepts Medicare17 mi
Ryan Perkins, M.D.
Radiation Oncology
NPI 1366447682
10881 SAN JOSE BLVD
Jacksonville, FL 32223
(904) 880-5522
✔ PECOS✔ Accepts Medicare17 mi
Alexandra Veno, APRN
Nurse Practitioner
NPI 1225803083
10881 SAN JOSE BLVD
Jacksonville, FL 32223
(904) 880-5522
✔ PECOS17 mi
Scot Ackerman, MD
Radiation Oncology
NPI 1942205364
10881 SAN JOSE BLVD
Jacksonville, FL 32223
(904) 880-5522
✔ PECOS✔ Accepts Medicare17 mi
Babita Jyoti, MD
Radiation Oncology
NPI 1780072942
10881 SAN JOSE BLVD
Jacksonville, FL 32223
(904) 260-3022
✔ PECOS✔ Accepts Medicare17 mi
Jaymeson Stroud, M.D.
Radiation Oncology
NPI 1619094513
10881 SAN JOSE BLVD
Jacksonville, FL 32223
(904) 880-5522
✔ PECOS✔ Accepts Medicare17 mi
Mallory Winnicki, NP
Nurse Practitioner
NPI 1609656867
13155 ATLANTIC BLVD
Jacksonville, FL 32225
(904) 490-7400
✔ PECOS23 mi
Mohamed Antar, MD
Urology
NPI 1972580298
2150 PARK ST
Jacksonville, FL 32204
(904) 384-8733
✔ PECOS26 mi
Leah Taylor
Nurse Practitioner
NPI 1730894262
915 W. MONROE STREET S. 300
Jacksonville, FL 32204
(904) 903-4345
✔ PECOS✔ Accepts Medicare27 mi
Gaelyn Scuderi, M.D.
Diagnostic Radiology
NPI 1750353207
655 W. 8TH STREET UNIVERSITY OF FLORIDA DEPARTMENT OF RADIOLOGY
Jacksonville, FL 32209
(904) 244-4225
✔ PECOS✔ Accepts Medicare28 mi
William Peters, MD, PH.D
Hematology/Oncology
NPI 1316272511
1551 S 14TH ST SUITE D
Amelia Island, FL 32034
(904) 493-5100
✔ PECOS46 mi
Mary Plymel
Nurse Practitioner
NPI 1194437103
1340 S 18TH ST
Amelia Island, FL 32034
(904) 277-2700
✔ PECOS46 mi
Robert Busch, D.O.
Urology
NPI 1063466811
4601 W US HIGHWAY 90
Lake City, FL 32055
(386) 752-4189
✔ PECOS✔ Accepts Medicare68 mi
Eric Ordinario, D.O.
Urology
NPI 1871545301
4601 W US HIGHWAY 90
Lake City, FL 32055
(386) 752-4189
✔ PECOS✔ Accepts Medicare76 mi
John Mcgetrick, M.D.
Urology
NPI 1497071047
810 N ROSE AVE
Kissimmee, FL 34741
(407) 943-7100
✔ PECOS✔ Accepts Medicare116 mi
Johnathan Hays, M.D.
Diagnostic Radiology
NPI 1366654162
110 KINGSLEY LN STE 305
Norfolk, VA 23505
(757) 889-5422
✔ PECOS✔ Accepts Medicare562 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ackerman Cancer Center, PA's NPI number?

The NPI number for Ackerman Cancer Center, PA is 1912786963. It was assigned to this organization in the NPPES registry on September 27, 2023.

Where is Ackerman Cancer Center, PA located?

Ackerman Cancer Center, PA is located at 533 W Twincourt Trl Ste 701, St Augustine, FL 32095. The listed phone number is (904) 490-7400.

What is Ackerman Cancer Center, PA's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Ackerman Cancer Center, PA enrolled in Medicare?

Yes. Ackerman Cancer Center, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ackerman Cancer Center, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 19 clinicians in 5 Medicare specialties reassign their Medicare billing to Ackerman Cancer Center, PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (7), Radiation Oncology (5) and Urology (4). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Ackerman Cancer Center, PA accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Ackerman Cancer Center, PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ackerman Cancer Center, PA was last updated on January 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.