NPIMap

Individual provider Active NPI

Shaneli Fernando, M.D.

  • Radiation Oncology Physician
  • Toledo, OH
National Provider Identifier
1508811654
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
69611-20 Issued in WI
Practice address
3000 Regency CT
Suite 207
Toledo, OH 43623-3092
Phone
(419) 471-0493
Fax
(419) 474-0390
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 239860 NY
Radiation Oncology Physician 2085R0001X SF078490 MI
Radiation Oncology Physician 2085R0001X 69611-20 WI Primary
Radiation Oncology Physician 2085R0001X 091524 OH

Addresses

Primary practice location

3000 Regency CT
Suite 207
Toledo, OH 43623-3092

Mailing address

3000 Regency CT
Suite 207
Toledo, OH 43623-3092
Phone (419) 471-0493

Other identifiers 6

IdentifierTypeStateIssuer
1508811654MedicaidMI
2837005MedicaidOH
P00630915OtherOHRR MEDICARE
P00630915OtherMIRR MEDICARE
0N24000018OtherMIMI MEDICARE
1508811654OtherMIMI MEDICAID - OH LOCATIONS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20180724002228 WI Practitioner - Radiation Oncology 4688687536 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newtro SCGroup PAC ID 7315437365, 7 clinicians

Practice addresses (Care Compare)

1580 Commanche Ave
Green Bay, WI 54313-5751
Phone (920) 358-1520

1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 358-1520

2500 E Capital Dr
Appleton, WI 54911-8735
Phone (920) 358-1520

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SF078490MIMDRadiation Oncology Physician
239860NYMDRadiation Oncology Physician
091524OHMDRadiation Oncology Physician
69611-20WIMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newtro SC CurrentSince Sep 29, 2025 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Aug 13, 2018 Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Aug 13, 2018 Accepting new patients
Radiology Associates of Appleton, S.C. Radiation Oncology CurrentSince Aug 1, 2018 Accepting new patients
Radiology Associates of Appleton, S.C. Radiation Oncology CurrentSince Aug 1, 2018 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Aug 13, 2018 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients

Locations

2500 E Capitol Dr
Appleton, WI 54911
Phone (920) 738-4600

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

1580 Commanche Ave
Green Bay, WI 54313
Phone (920) 431-5687

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Organizations & group practices 8

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1508811654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 REGENCY CT",
            "address_2": "SUITE 207",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233092",
            "telephone_number": "419-471-0493",
            "fax_number": "419-474-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 REGENCY CT",
            "address_2": "SUITE 207",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233092",
            "telephone_number": "419-471-0493",
            "fax_number": "419-474-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "SHANELI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "239860",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "SF078490",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WI",
            "license": "69611-20",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OH",
            "license": "091524",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508811654",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2837005",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00630915",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00630915",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI MEDICARE",
            "identifier": "0N24000018",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI MEDICAID - OH LOCATIONS",
            "identifier": "1508811654",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.