NPIMap

Organization Active NPI

Radiation Oncology Associates Inc

  • Radiation Oncology Physician
  • Providence, RI
National Provider Identifier
1376546267
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
RADIATION ONCOLOGY ASSOCIATES INC
Practice address
825 N Main St
Providence, RI 02904-5707
Phone
(401) 521-9700
Fax
(401) 751-1686
NPI assigned
May 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Authorized official

Name
Dr. Nicklas E. Oldenburg, M.D.
Title
President
Phone
(401) 521-9700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

825 N Main St
Providence, RI 02904-5707

Mailing address

825 N Main St
Providence, RI 02904-5707
Phone (401) 521-9700

Other identifiers 2

IdentifierTypeStateIssuer
9000233MedicaidRI
CE6091OtherRIRR MEDICARE

Other names 1

  • NorthMain Radiation Oncology Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address NM.RadOnc@directaddress.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151030001436 RI Part B Supplier - Clinic/Group Practice 9335190446 Receives reassigned benefits from 6 practitioners
Practice locations: Providence, RI

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: nm.radonc@directaddress.net

Practitioners & affiliated clinicians

Practitioners 6

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": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1376546267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045707",
            "telephone_number": "401-521-9700",
            "fax_number": "401-751-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045707",
            "telephone_number": "401-521-9700",
            "fax_number": "401-751-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIATION ONCOLOGY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "OLDENBURG",
        "authorized_official_first_name": "NICKLAS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-521-9700",
        "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000233",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE6091",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NM.RadOnc@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "825 N Main St",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029045707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "NorthMain Radiation Oncology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NorthMain Radiation Oncology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.