Edward C Greenleaf

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

G51488 Issued in CA

Legal business name

EDWARD C GREENLEAF

Practice address

2027 Grand Canal Blvd Ste 25
Stockton, CA 95207-6650

Phone

(209) 475-1111

Fax

(209) 475-1119

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Edward C Greenleaf, M.D.NPI 1629158340

Title

Medical Director

Phone

(209) 481-8312

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• RADIATION ONCOLOGY MEDICAL ASSOCIATES Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward C. Greenleaf, M.D.

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1629158340

  Radiation Oncology

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1346468840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952010014",
            "telephone_number": "209-475-1111",
            "fax_number": "209-475-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2027 GRAND CANAL BLVD STE 25",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076650",
            "telephone_number": "209-475-1111",
            "fax_number": "209-475-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD C GREENLEAF",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "GREENLEAF",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "209-481-8312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "G51488",
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "CA",
            "license": "G51488",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0044200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RADIATION ONCOLOGY MEDICAL ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edington Medical Evaluations
• Philip A Edington, M.D.
• Edith Mora DMD, Inc.
• Karen Lynette Edmond
• Edmund Yao MD Inc
• Edward Schneider MD Inc
• Mari Lynn Edwardes
• Paris Janell Edwards
• Kelly Lynn Effinger
• Angela Egbuchulam

• Radiation Oncology Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Radiation Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.