Organization Active NPI

Radiant Oncology Medical Group

  • Radiation Oncology Physician
  • Rancho Mirage, CA
National Provider Identifier
1164293106
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
RADIANT ONCOLOGY MEDICAL GROUP
Practice address
40055 Bob Hope Dr
Rancho Mirage, CA 92270-3937
Phone
(760) 202-3946
NPI assigned
Jan 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Mr. Syed Ziaulla
Title
Coo
Phone
(562) 492-6695

Specialties & licenses 1

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

Addresses

Primary practice location

40055 Bob Hope Dr
Rancho Mirage, CA 92270-3937

Mailing address

2650 Elm Ave Ste 201
Long Beach, CA 90806-1600
Phone (562) 492-6695

Other practice location 1

77840 Flora Rd
Palm Desert, CA 92211-4109
Phone (760) 200-8777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240627001359 CA Part B Supplier - Clinic/Group Practice 6002350378 Receives reassigned benefits from 2 practitioners
Practice locations: Palm Desert, CA; Rancho Mirage, CA

National Provider Directory

National Provider Directory

Locations

40055 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 202-3946

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1164293106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 ELM AVE STE 201",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061600",
            "telephone_number": "562-492-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40055 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703937",
            "telephone_number": "760-202-3946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77840 Flora Rd",
            "address_purpose": "LOCATION",
            "city": "Palm Desert",
            "state": "CA",
            "postal_code": "922114109",
            "country_code": "US",
            "telephone_number": "760-200-8777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RADIANT ONCOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "ZIAULLA",
        "authorized_official_first_name": "SYED",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "562-492-6695",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.