Organization Active NPI

Gagnon Oncology, LLC

  • Radiation Oncology Physician
  • Frederick, MD
National Provider Identifier
1376814293
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
D0039954 Issued in MD
Legal business name
GAGNON ONCOLOGY, LLC
Practice address
1562 Opossumtown Pike
Frederick, MD 21702-4920
Phone
(240) 566-4500
Fax
(301) 694-5554
NPI assigned
Jan 24, 2012
Organization subpart
Yes
Parent organization
GAGNON ONCOLOGY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
Lynda D Losecco
Title
Administrator
Phone
(607) 324-2340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X D0039954 MD Primary

Addresses

Primary practice location

1562 Opossumtown Pike
Frederick, MD 21702-4920

Mailing address

111 Loder St Ste B
Hornell, NY 14843-1950
Phone (888) 465-5278

Other practice location 1

11110 Medical Campus Rd Ste 129
Hagerstown, MD 21742-6799
Phone (301) 665-4650

Other identifiers 1

IdentifierTypeStateIssuer
758511000MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120228000537 MD Part B Supplier - Clinic/Group Practice 5496913030 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Mount Airy, MD; Hagerstown, MD; Frederick, MD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gagnon Oncology LLC2 organizations share this tax ID, including this one
Part of
Gagnon Oncology LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

501 W 7th St
Ste 2
Frederick, MD 21701
Phone (240) 566-4500

501 W 7th St
Ste C
Frederick, MD 21701

11110 Medical Campus Rd
Ste 129
Hagerstown, MD 21742
Phone (301) 665-4650

111 Loder St
#B
Hornell, NY 14843

Practitioners & affiliated clinicians

Practitioners 5

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": "1327363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1376814293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LODER ST STE B",
            "city": "HORNELL",
            "state": "NY",
            "postal_code": "148431950",
            "telephone_number": "888-465-5278",
            "fax_number": "607-324-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1562 OPOSSUMTOWN PIKE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024920",
            "telephone_number": "240-566-4500",
            "fax_number": "301-694-5554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11110 Medical Campus Rd Ste 129",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217426799",
            "country_code": "US",
            "telephone_number": "301-665-4650",
            "fax_number": "301-665-4648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GAGNON ONCOLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GAGNON ONCOLOGY, LLC",
        "enumeration_date": "2012-01-24",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "LOSECCO",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "607-324-2340"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "MD",
            "license": "D0039954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "758511000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.