NPIMap

Organization Active NPI

Cancer Care Group P.C.

  • Radiation Oncology Physician
  • Anderson, IN
National Provider Identifier
1083986517
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
50004183A Issued in IN
Legal business name
CANCER CARE GROUP P.C.
Practice address
2020 Meridian Street
Suite 100
Anderson, IN 46016-4338
Phone
(765) 646-8358
Fax
(765) 646-8413
NPI assigned
Jan 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Authorized official

Name
Mr. Stephen A Freeland
Title
Ceo
Phone
(317) 715-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X 50004183A IN Primary

Addresses

Primary practice location

2020 Meridian Street
Suite 100
Anderson, IN 46016-4338

Mailing address

6100 W 96TH St
Suite 125
Indianapolis, IN 46278-6006
Phone (317) 715-1800

Other identifiers 1

IdentifierTypeStateIssuer
200259350MedicaidIN

Other names 1

  • Cancer Care Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000316 IN Part B Supplier - Clinic/Group Practice 1850295858 Receives reassigned benefits from 23 practitioners
31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Indianapolis, IN; Kokomo, IN; Lafayette, IN; Lebanon, IN; Logansport, IN; Mooresville, IN; Noblesville, IN; Peru, IN…

Other NPIs on the same Medicare enrollment 31

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 31

National Provider Directory

National Provider Directory
Tax ID family
Cancer Care Group PC36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1083986517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 W 96TH ST",
            "address_2": "SUITE 125",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462786006",
            "telephone_number": "317-715-1800",
            "fax_number": "317-715-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 MERIDIAN STREET",
            "address_2": "SUITE 100",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164338",
            "telephone_number": "765-646-8358",
            "fax_number": "765-646-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CARE GROUP P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "FREELAND",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-715-1800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "IN",
            "license": "50004183A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200259350",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cancer Care Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.