Individual provider Active NPI

Todd Mereniuk, M.D./PH.D.

  • Radiation Oncology Physician
  • Oxford, MS
National Provider Identifier
1477917409
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
28747 Issued in MS
Practice address
504 Azalea Dr Dept of
Oxford, MS 38655-5397
Phone
(662) 636-4300
NPI assigned
Apr 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Radiation Oncology Physician 2085R0001X 28747 MS Primary

Addresses

Primary practice location

504 Azalea Dr Dept of
Oxford, MS 38655-5397

Mailing address

504 Azalea Dr Dept of
Oxford, MS 38655-5397

Other practice location 1

500 J Clyde Morris Blvd Fl 2
Newport News, VA 23601-1929
Phone (757) 594-3945

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210609002412 MS Practitioner - Radiation Oncology 0446520639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Tulane University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

504 Azalea Dr
Oxford, MS 38655-5397
Phone (662) 636-4444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28747MSMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Todd Mereniuk, PLLC Radiation Oncology CurrentSince May 12, 2021 Accepting new patients

Locations

504 Azalea Dr
Oxford, MS 38655
Phone (662) 513-9600

Interoperability endpoints

  • Direct secure messaging: tmereniuk471123@direct.bmhcc.org

Organizations & group practices 1

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

Hospital & facility affiliations 2

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1477917409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 AZALEA DR DEPT OF",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 AZALEA DR DEPT OF",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555397",
            "telephone_number": "662-636-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 J Clyde Morris Blvd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236011929",
            "country_code": "US",
            "telephone_number": "757-594-3945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERENIUK",
        "first_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "M.D./PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MS",
            "license": "28747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.