Individual provider Active NPI

Julia Manzerova, M.D./PH.D.

  • Radiation Oncology Physician
  • Brewer, ME
National Provider Identifier
1336409663
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD26837 Issued in ME
Practice address
33 Whiting Hill Rd Ste 1
Brewer, ME 04412-1022
Phone
(207) 973-4280
NPI assigned
May 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 271768 NY
Radiation Oncology Physician 2085R0001X MD26837 ME Primary

Addresses

Primary practice location

33 Whiting Hill Rd Ste 1
Brewer, ME 04412-1022

Mailing address

33 Whiting Hill Road
Suite 1
Brewer, ME 04412
Phone (207) 973-4460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, ME2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170727001042 NY Practitioner - Radiation Oncology 9335419118 Reassigns benefits to 5 organizations
I20230712002614 ME Practitioner - Radiation Oncology 9335419118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Albert Einstein College of Medicine of Yeshiva University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Radiation Oncology PAGroup PAC ID 7214964196, 4 clinicians

Practice addresses (Care Compare)

33 Whiting Hill Rd
Lafayette Family Cancer Center
Brewer, ME 04412-1004
Phone (207) 973-7499

Hospital & facility affiliations

  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
  • St Joseph Hospital Hospital, Bangor, ME, CCN 200001
  • Down East Community Hospital Hospital, Machias, ME, CCN 201311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
271768NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC Radiation Oncology CurrentSince Feb 18, 2019 Accepting new patients
Kings Physician Services, PC CurrentSince Feb 18, 2019 Accepting new patients
Weill Medical College of Cornell CurrentSince Aug 1, 2017 Accepting new patients
Northeast Radiation Oncology PA Radiation Oncology CurrentSince Sep 23, 2024 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jul 1, 2019 Accepting new patients
Weill Medical College of Cornell Radiation Oncology CurrentSince Aug 1, 2017 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jul 1, 2019 Accepting new patients
Weill Medical College of Cornell Radiation Oncology CurrentSince Aug 1, 2017 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients

Locations

417 State St
Ste 20
Bangor, ME 04401
Phone (207) 973-7478

33 Whiting Hill Rd
Ste 1
Brewer, ME 04412
Phone (207) 973-7499

33 Whiting Hill Rd
Brewer, ME 04412
Phone (207) 973-7478

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

460 Andes Rd
Delhi, NY 13753
Phone (607) 746-0300

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

130 North St
Walton, NY 13856
Phone (607) 865-6541

Organizations & group practices 9

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": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1336409663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WHITING HILL ROAD",
            "address_2": "SUITE 1",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "04412",
            "telephone_number": "207-973-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 WHITING HILL RD STE 1",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121022",
            "telephone_number": "207-973-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZEROVA",
        "first_name": "JULIA",
        "credential": "M.D./PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "271768",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "ME",
            "license": "MD26837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewer, ME

Sources for this page

Verify at the official NPI Registry.