Individual provider Active NPI

Rhonaldo Agung Silaban, MD

  • Emergency Medicine Physician
  • Oswego, NY
National Provider Identifier
1013327741
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C177285 Issued in CA
Practice address
110 W 6TH St
Oswego, NY 13126-2507
Phone
(315) 349-5511
NPI assigned
May 2, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C177285 CA Primary
Emergency Medicine Physician 207P00000X 288385 NY
Emergency Medicine Physician 207P00000X MD461120 PA

Addresses

Primary practice location

110 W 6TH St
Oswego, NY 13126-2507

Mailing address

615 James St - B04
Syracuse, NY 13210-2306
Phone (310) 873-7455

Other practice location 1

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-4363

Other practice location 2

206 E Brown St
East Stroudsburg, PA 18301-3006
Phone (570) 421-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20221228001211 CA Practitioner - Emergency Medicine 3274804596 Reassigns benefits to 2 organizations
Practice locations: Hayward, CA

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loma Linda University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

27200 Calaroga Ave
Hayward, CA 94545-4339
Phone (510) 264-4026

Hospital & facility affiliations

  • St Rose Hospital Hospital, Hayward, CA, CCN 050002

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C177285CAMDEmergency Medicine Physician
MD461120PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Nov 1, 2023 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Nes Western Group, a Professional Corporation Emergency Medicine CurrentSince Jun 21, 2022 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Nov 1, 2023 Accepting new patients
Nes Western Group, a Professional Corporation Emergency Medicine Current Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

27200 Calaroga Ave
Hayward, CA 94545
Phone (510) 264-2000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1013327741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 JAMES ST - B04",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "310-873-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262507",
            "telephone_number": "315-349-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Adams St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102306",
            "country_code": "US",
            "telephone_number": "315-464-4363",
            "fax_number": "315-464-4854",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 E Brown St",
            "address_purpose": "LOCATION",
            "city": "East Stroudsburg",
            "state": "PA",
            "postal_code": "183013006",
            "country_code": "US",
            "telephone_number": "570-421-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SILABAN",
        "first_name": "RHONALDO",
        "middle_name": "AGUNG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C177285",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "288385",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD461120",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.