Individual provider Active NPI

Vinita Patanaphan, MD

  • Radiation Oncology Physician
  • Belcamp, MD
National Provider Identifier
1356323570
Registry record updated Jan 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
D21798 Issued in MD
Practice address
1200 Brass Mill Rd
Suite E
Belcamp, MD 21017-1217
Phone
(410) 272-9224
Fax
(410) 575-7591
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X D21798 MD Primary

Addresses

Primary practice location

1200 Brass Mill Rd
Suite E
Belcamp, MD 21017-1217

Mailing address

2234 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other identifiers 8

IdentifierTypeStateIssuer
649911200MedicaidMD
1043770OtherMDCIGNA PROVIDER #
4421117OtherMDAETNA PROVIDER #
01189076OtherMDAMERIGROUP
34578005OtherMDCARE FIRST BCBS PROV. #
6882-0002OtherMDCAREFIRST BCBS- DC
154681300MedicaidMD
5160OtherMDELDER HEALTH PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20061019000570 MD Practitioner - Radiation OncologyPractitioner - Diagnostic Radiology 1658300348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-6080

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Radiation Oncology Associates PA Radiation Oncology CurrentSince Oct 17, 2016 Accepting new patients
Vinita Patanaphan MD PA Radiation Oncology Past Accepting new patients

Locations

22 S Greene St
Bsmt
Baltimore, MD 21201
Phone (410) 328-3037

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

500 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (443) 643-1000

152 Railroad Ave
Elkton, MD 21921
Phone (443) 907-1650

Interoperability endpoints

  • Direct secure messaging: vpatanaphan472964@direct.umm.edu

Organizations & group practices 2

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 2

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232323200000",
    "number": "1356323570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BRASS MILL RD",
            "address_2": "SUITE E",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210171217",
            "telephone_number": "410-272-9224",
            "fax_number": "410-575-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATANAPHAN",
        "first_name": "VINITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2009-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MD",
            "license": "D21798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "649911200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER #",
            "identifier": "1043770",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER #",
            "identifier": "4421117",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01189076",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST BCBS PROV. #",
            "identifier": "34578005",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS- DC",
            "identifier": "6882-0002",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154681300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDER HEALTH PROVIDER #",
            "identifier": "5160",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belcamp, MD

Sources for this page

Verify at the official NPI Registry.