NPIMap

Individual provider Active NPI

Uri Martin Zisblatt, M.D.

  • Radiation Oncology Physician
  • Covina, CA
National Provider Identifier
1114921616
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
G80195 Issued in CA
Practice address
210 W San Bernardino Rd
Dept of Rad Onc
Covina, CA 91723-1515
Phone
(626) 915-6280
Fax
(626) 859-5829
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X G80195 CA Primary

Addresses

Primary practice location

210 W San Bernardino Rd
Dept of Rad Onc
Covina, CA 91723-1515

Mailing address

210 W San Bernardino Rd
Dept of Rad Onc
Covina, CA 91723-1515
Phone (626) 915-6280

Other identifiers 5

IdentifierTypeStateIssuer
00G801950MedicaidCA
P00796214OtherCARAILROAD MEDICARE
920003242OtherRAILROAD MEDICARE
5568573OtherCAAETNA
4988508OtherCACIGNA PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
80195CAMDPharmacist
G80195CAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Dimas Community Hospital, Inc. Past Accepting new patients
Cancer Care Consultants Medical Associates Radiation Oncology Past Accepting new patients
The Regents of the University of California Past Accepting new patients
Cedars-Sinai Marina Hospital Past Accepting new patients
Genesiscare USA of California a Medical Corporation Radiation Oncology Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Dignity Community Care Past Accepting new patients
Genesiscare USA of California a Medical Corporation Radiation Oncology Past Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1114921616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W SAN BERNARDINO RD",
            "address_2": "DEPT OF RAD ONC",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231515",
            "telephone_number": "626-915-6280",
            "fax_number": "626-859-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W SAN BERNARDINO RD",
            "address_2": "DEPT OF RAD ONC",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231515",
            "telephone_number": "626-915-6280",
            "fax_number": "626-859-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZISBLATT",
        "first_name": "URI",
        "middle_name": "MARTIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "G80195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G801950",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00796214",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "920003242",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5568573",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER #",
            "identifier": "4988508",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.