Eastern Shore Radiation Oncology Assoc., P.a.

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

D0036644 Issued in MD

Legal business name

EASTERN SHORE RADIATION ONCOLOGY ASSOC., P.A.

Practice address

509 Idlewild Ave
Easton, MD 21601

Phone

(410) 820-6411

Fax

(410) 820-4229

NPI assigned

Oct 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Philip Mastandrea, M.D.

Title

President

Phone

(410) 820-6411

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526947200000",
    "number": "1386832129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 IDLEWILD AVE",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216013889",
            "telephone_number": "410-820-6411",
            "fax_number": "410-820-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 IDLEWILD AVE",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "21601",
            "telephone_number": "410-820-6411",
            "fax_number": "410-820-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE RADIATION ONCOLOGY ASSOC., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2018-05-22",
        "status": "A",
        "authorized_official_last_name": "MASTANDREA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-820-6411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "MD",
            "license": "D0036644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088861300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastern Shore Lithotripsy
• Eastern Shore Oncology PC
• Eastern Shore Psychological Services LLC
• Eastern Shore Psychological Services, LLC
• Eastern Shore Psychological Services, LLC
• Eastern Shore Surgery Center LLC
• Eastern Shore Urology Associates, PA
• Easton Advanced Aesthetics and Integrative Medicine
• Easton Anesthesia Associates LLC
• Easton Dental Studio LLC

• Radiation Oncology Physician in Easton, MD
• Providers in Easton, MD by specialty
• Radiation Oncology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.