Individual provider Active NPI

Lisa June Virostek, MD

  • Radiation Oncology Physician
  • Cleveland, TN
National Provider Identifier
1174547277
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD28495 Issued in TN
Practice address
2620 Peerless Rd NW
Cleveland, TN 37312-3732
Phone
(423) 472-2171
Fax
(423) 559-8032
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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 MD28495 TN Primary

Addresses

Primary practice location

2620 Peerless Rd NW
Cleveland, TN 37312-3732

Mailing address

2620 Peerless Rd NW
Cleveland, TN 37312-3732
Phone (423) 472-2171

Other identifiers 1

IdentifierTypeStateIssuer
3804203MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20100630000448 TN Practitioner - Radiation Oncology 8820142722 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Tennessee, HSC, College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2620 Peerless Rd NW
Cleveland, TN 37312-3732
Phone (423) 472-2171

Hospital & facility affiliations

  • Affiliate of Vitruvian Health Hospital, Cleveland, TN, CCN 440185
  • Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD28495TNMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiation Therapy Associates PC CurrentSince Jun 1, 2010 Accepting new patients
Athens Regional Cancer Center PLLC CurrentSince May 1, 2010 Accepting new patients

Locations

680 S White St
Athens, TN 37303
Phone (423) 252-1580

2620 Peerless Rd NW
Cleveland, TN 37312
Phone (423) 472-2171

Organizations & group practices 2

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 3

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1174547277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 PEERLESS RD NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123732",
            "telephone_number": "423-472-2171",
            "fax_number": "423-559-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 PEERLESS RD NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123732",
            "telephone_number": "423-472-2171",
            "fax_number": "423-559-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIROSTEK",
        "first_name": "LISA",
        "middle_name": "JUNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TN",
            "license": "MD28495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3804203",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.