Organization Active NPI

Vijay Kini MD. Inc.

Doing business as Radiation Oncology Medical Group of Southern CA, Inc.

  • Radiation Oncology Physician
  • Tustin, CA
National Provider Identifier
1265463970
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
VIJAY KINI MD. INC.
Doing business as
Radiation Oncology Medical Group of Southern CA, Inc.
Practice address
2895 Edinger Ave
Tustin, CA 92780-7257
Phone
(949) 381-5800
Fax
(949) 552-5152
NPI assigned
Jul 5, 2006
Last updated
Apr 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Authorized official

Name
Vijaykumar R Kini, MDNPI 1417940198
Title
Owner
Phone
(949) 381-5800

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 Physician 2085R0001X CA Primary

Addresses

Primary practice location

2895 Edinger Ave
Tustin, CA 92780-7257

Mailing address

PO Box 101455
Pasadena, CA 91189-1455
Phone (770) 693-2622

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ77835ZMedicaidCA

Other names 1

  • Radiation Oncology Medical Group of Southern CA, Inc. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051202000365 CA Part B Supplier - Clinic/Group Practice 0749200947 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA; Tustin, CA; Placentia, CA; Newport Beach, CA; Fountain Valley, CA

National Provider Directory

National Provider Directory
Tax ID family
Radiation Oncology Medical Group of Southern Ca Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1041 E Yorba Linda Blvd
#100
Placentia, CA 92870
Phone (714) 579-7575

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1265463970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101455",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911891455",
            "telephone_number": "770-693-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2895 EDINGER AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807257",
            "telephone_number": "949-381-5800",
            "fax_number": "949-552-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIJAY KINI MD. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "KINI",
        "authorized_official_first_name": "VIJAYKUMAR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-381-5800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ77835Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiation Oncology Medical Group of Southern CA, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.