NPIMap

Organization Active NPI

Northeast Regional Radiation Oncology Network Inc

  • Radiation Oncology Physician
  • Manchester, CT
National Provider Identifier
1467516773
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
NORTHEAST REGIONAL RADIATION ONCOLOGY NETWORK INC
Practice address
100 Haynes St
Manchester, CT 06040-4113
Phone
(860) 533-4000
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Daniel Delgallo
Title
Executive Director
Phone
(860) 646-1222

Specialties & licenses 1

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

Addresses

Primary practice location

100 Haynes St
Manchester, CT 06040-4113

Mailing address

2864 Johnson Ferry Rd
Suite 150
Marietta, GA 30062-8345
Phone (770) 693-2622

Other identifiers 8

IdentifierTypeStateIssuer
004214293MedicaidCT
33006856OtherCTCIGNA
61426856OtherCTSAGA
2139370OtherCTAETNA MEDICARE
A1725354OtherCTOXFORD
2158621OtherCTAETNA USHC
954221OtherCTCONNECTICARE
68RDONC01CT1OtherCTANTHEM BS

Other names 1

  • Community Cancer Care Doing business as

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

73 Haynes St
#A
Manchester, CT 06040
Phone (860) 533-4000

100 Haynes St
Manchester, CT 06040
Phone (860) 533-2929

2864 Johnson Ferry Rd
Ste 150
Marietta, GA 30062

Practitioners & affiliated clinicians

Practitioners 11

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": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1467516773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2864 JOHNSON FERRY RD",
            "address_2": "SUITE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628345",
            "telephone_number": "770-693-2622",
            "fax_number": "770-693-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404113",
            "telephone_number": "860-533-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST REGIONAL RADIATION ONCOLOGY NETWORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DELGALLO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "860-646-1222"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004214293",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "33006856",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAGA",
            "identifier": "61426856",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA MEDICARE",
            "identifier": "2139370",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "A1725354",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC",
            "identifier": "2158621",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "954221",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BS",
            "identifier": "68RDONC01CT1",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Cancer Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.