NPIMap

Organization Active NPI

Coastal Radiation Oncology Medical Group, Inc.

  • Radiation Oncology Physician
  • Santa Maria, CA
National Provider Identifier
1093749129
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC.
Practice address
1325 E Church St Ste 101
Santa Maria, CA 93454-5915
Phone
(805) 925-2529
Fax
(805) 928-4478
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Authorized official

Name
Dr. Jeffrey M Rodnick, M.D.NPI 1972595882
Title
President
Phone
(805) 648-5191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1325 E Church St Ste 101
Santa Maria, CA 93454-5915

Mailing address

1325 E Church St Ste 101
Santa Maria, CA 93454-5915
Phone (800) 437-1619

Other names 1

  • Santa Maria Radiation Oncology Medical Center, Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coastal Radiation Oncology Medical Group Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

314 S Stratford Ave
Santa Maria, CA 93454
Phone (805) 922-5655

274 Heather Ct
Templeton, CA 93465
Phone (805) 434-1859

274 Heather Ct
#A
Templeton, CA 93465
Phone (805) 434-1859

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1093749129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E CHURCH ST STE 101",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545915",
            "telephone_number": "800-437-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E CHURCH ST STE 101",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545915",
            "telephone_number": "805-925-2529",
            "fax_number": "805-928-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "RODNICK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-648-5191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Maria Radiation Oncology Medical Center, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Santa Maria Radiation Oncology Medical Center, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.