NPIMap

Organization Active NPI

Ventura County Radiation Oncology Medical Group, Inc.

  • Radiation Oncology Physician
  • Oxnard, CA
National Provider Identifier
1386609725
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
G58104 Issued in CA
Legal business name
VENTURA COUNTY RADIATION ONCOLOGY MEDICAL GROUP, INC.
Practice address
1700 N Rose Ave
Suite 120
Oxnard, CA 93030-3790
Phone
(805) 988-2657
Fax
(805) 981-4456
NPI assigned
Apr 19, 2006
Last updated
Dec 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Authorized official

Name
Dr. Timothy A. Oconnor, M.D.NPI 1982669396
Title
President
Phone
(805) 988-2657

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X G58104 CA Primary

Addresses

Primary practice location

1700 N Rose Ave
Suite 120
Oxnard, CA 93030-3790

Mailing address

1700 N Rose Ave
Suite 120
Oxnard, CA 93030-3790
Phone (805) 988-2657

Other identifiers 1

IdentifierTypeStateIssuer
GR0040690MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000828 CA Part B Supplier - Clinic/Group Practice 4981517083 Receives reassigned benefits from 2 practitioners
Practice locations: Camarillo, CA; Oxnard, CA

National Provider Directory

National Provider Directory

Locations

2460 N Ponderosa Dr
Ste A101
Camarillo, CA 93010
Phone (805) 482-1136

3801 Las Posas Rd
Ste 106
Camarillo, CA 93010
Phone (805) 383-1567

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1386609725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N ROSE AVE",
            "address_2": "SUITE 120",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930303790",
            "telephone_number": "805-988-2657",
            "fax_number": "805-981-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N ROSE AVE",
            "address_2": "SUITE 120",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930303790",
            "telephone_number": "805-988-2657",
            "fax_number": "805-981-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENTURA COUNTY RADIATION ONCOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-988-2657",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "G58104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0040690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; 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.