NPIMap

Organization Active NPI

Santa Cruz Radiation Oncology Medical Group, Incorporated

  • Radiation Oncology Physician
  • Santa Cruz, CA
National Provider Identifier
1306988381
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
SANTA CRUZ RADIATION ONCOLOGY MEDICAL GROUP, INCORPORATED
Practice address
1575 Soquel Dr
Suite 100
Santa Cruz, CA 95065-1700
Phone
(831) 462-3050
Fax
(831) 462-6068
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Authorized official

Name
Dr. Jay A. Meisel, M.D.NPI 1720140353
Title
President
Phone
(831) 462-3050

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

1575 Soquel Dr
Suite 100
Santa Cruz, CA 95065-1700

Mailing address

1575 Soquel Dr
Suite 100
Santa Cruz, CA 95065-1700
Phone (831) 462-3050

Other identifiers 2

IdentifierTypeStateIssuer
DF7086OtherCAMEDICARE RR
GR0007340MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070613000815 CA Part B Supplier - Radiation Therapy Center 0446358543 Receives reassigned benefits from 3 practitioners
Practice locations: Santa Cruz, CA

National Provider Directory

National Provider Directory

Locations

1575 Soquel Dr
Ste 100
Santa Cruz, CA 95065
Phone (831) 462-3050

1505 Soquel Dr
Ste 9
Santa Cruz, CA 95065
Phone (831) 462-8960

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 10

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": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1306988381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 SOQUEL DR",
            "address_2": "SUITE 100",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651700",
            "telephone_number": "831-462-3050",
            "fax_number": "831-462-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 SOQUEL DR",
            "address_2": "SUITE 100",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651700",
            "telephone_number": "831-462-3050",
            "fax_number": "831-462-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA CRUZ RADIATION ONCOLOGY MEDICAL GROUP, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "MEISEL",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-462-3050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "DF7086",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0007340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.