Organization Active NPI

Leading Edge Radiation Oncology Services, PLLC

  • Radiation Oncology Physician
  • Brooklyn, NY
National Provider Identifier
1306923875
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
LEADING EDGE RADIATION ONCOLOGY SERVICES, PLLC
Practice address
8715 5TH Avenue
Brooklyn, NY 11209
Phone
(718) 836-2200
Fax
(718) 836-2226
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Authorized official

Name
Sameer Rafla, MD
Title
President
Phone
(718) 836-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

8715 5TH Avenue
Brooklyn, NY 11209

Mailing address

8715 5TH Avenue
Brooklyn, NY 11209
Phone (718) 836-2200

Other identifiers 1

IdentifierTypeStateIssuer
0250011BMedicaidNY

National Provider Directory

National Provider Directory

Locations

9920 4th Ave
Ste 314
Brooklyn, NY 11209
Phone (718) 836-2200

8715 5th Ave
Brooklyn, NY 11209
Phone (718) 836-2200

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433289600000",
    "number": "1306923875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8715 5TH AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11209",
            "telephone_number": "718-836-2200",
            "fax_number": "718-836-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8715 5TH AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11209",
            "telephone_number": "718-836-2200",
            "fax_number": "718-836-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEADING EDGE RADIATION ONCOLOGY SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-06-03",
        "status": "A",
        "authorized_official_last_name": "RAFLA",
        "authorized_official_first_name": "SAMEER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-836-2200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0250011B",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; 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.