Individual provider Active NPI

Nikhil Gadahad Rao, MD

  • Radiation Oncology Physician
  • Rohnert Park, CA
National Provider Identifier
1275737850
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
C140465 Issued in CA
Practice address
301 Professional Center Dr
Rohnert Park, CA 94928
Phone
(877) 866-0914
NPI assigned
Jun 14, 2007
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X ME102445 FL
Radiation Oncology Physician 2085R0001X M6354 TX
Radiation Oncology Physician 2085R0001X C140465 CA Primary

Addresses

Primary practice location

301 Professional Center Dr
Rohnert Park, CA 94928

Mailing address

PO Box 756
Danville, CA 94526-0756
Phone (877) 866-0914

Other practice location 1

601 E Rollins St
Radiation Oncology
Orlando, FL 32803-1248
Phone (407) 303-5857

Other identifiers 2

IdentifierTypeStateIssuer
2775609985OtherMYUTMB 2775609985-COMMERCIAL NUMBER
1275737850MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170804001353 CA Practitioner - Radiation Oncology 9436226834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Virginia School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cancer Therapy Medical Group IncGroup PAC ID 6800792003, 12 clinicians

Practice addresses (Care Compare)

301 Professional Ctr Dr
Rohnert Park, CA 94928-2152
Phone (707) 584-2200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C140465CAMDRadiation Oncology Physician
M6354TXMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Therapy Medical Group Inc Radiation Oncology CurrentSince Sep 1, 2017 Accepting new patients
Cancer Therapy Medical Group Inc Radiation Oncology CurrentSince Sep 1, 2017 Accepting new patients
Cancer Therapy Medical Group Inc Radiation Oncology Current Accepting new patients

Locations

7887 N Cedar Ave
Fresno, CA 93720
Phone (559) 320-4300

301 Professional Center Dr
Rohnert Park, CA 94928
Phone (707) 584-2200

Interoperability endpoints

  • Direct secure messaging: nrao378036@hisp.ehr.sutterhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1275737850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 756",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945260756",
            "telephone_number": "877-866-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROFESSIONAL CENTER DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "94928",
            "telephone_number": "877-866-0914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 E Rollins St",
            "address_2": "Radiation Oncology",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328031248",
            "country_code": "US",
            "telephone_number": "407-303-5857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAO",
        "first_name": "NIKHIL",
        "middle_name": "GADAHAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME102445",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "M6354",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "C140465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MYUTMB 2775609985-COMMERCIAL NUMBER",
            "identifier": "2775609985",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275737850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

Verify at the official NPI Registry.