NPIMap

Individual provider Active NPI

Thomas Eanelli, M.D.

  • Radiation Oncology Physician
  • Middletown, NY
National Provider Identifier
1407800915
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
1724171 Issued in NY
Practice address
707 E Main St
Middletown, NY 10940-2650
Phone
(845) 333-2326
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 25MA05095900 NJ
Radiation Oncology Physician 2085R0001X 1724171 NY Primary

Addresses

Primary practice location

707 E Main St
Middletown, NY 10940-2650

Mailing address

PO Box 4829
Middletown, NY 10941
Phone (845) 649-5566

Other identifiers 2

IdentifierTypeStateIssuer
4596501MedicaidNJ
01273703MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031114000103 NY Practitioner - Radiation Oncology 0941114946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-2326

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1724171NYMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas R. Eanelli Radiation Oncology Services, PLLC Radiation Oncology CurrentSince Aug 1, 2010 Accepting new patients
Catskill Radiation Oncology Consultants, PLLC Radiation Oncology Past Accepting new patients
Valley Radiation Oncology Assoc PA Radiation Oncology Past Accepting new patients
Goshen Medical Associates PC Past Accepting new patients

Locations

1 International Blvd
Ste 1130
Mahwah, NJ 07495

70 Hatfield Ln
Ste 103
Goshen, NY 10924
Phone (845) 291-3623

60 Prospect Ave
Middletown, NY 10940
Phone (845) 342-2424

707 E Main St
Middletown, NY 10940
Phone (845) 333-1000

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: teanelli9404@direct.garnethealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1407800915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4829",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "10941",
            "telephone_number": "845-649-5566",
            "fax_number": "845-294-9656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EANELLI",
        "first_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NJ",
            "license": "25MA05095900",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "1724171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4596501",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01273703",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.