NPIMap

Individual provider Active NPI

John Philip Mastandrea, M.D.

  • Radiation Oncology Physician
  • Easton, MD
National Provider Identifier
1518999697
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
D0036644 Issued in MD
Practice address
509 Idlewild Ave
Easton, MD 21601-3825
Phone
(410) 820-6411
Fax
(410) 820-4229
NPI assigned
Jul 7, 2006
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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 83159 SC
Radiation Oncology Physician 2085R0001X D0036644 MD Primary

Addresses

Primary practice location

509 Idlewild Ave
Easton, MD 21601-3825

Mailing address

509 Idlewild Ave
Easton, MD 21601-3889
Phone (410) 924-0174

Other practice location 1

7 Richland Medical Park Dr Ste 104
Columbia, SC 29203-6863
Phone (803) 434-6105

Other identifiers 1

IdentifierTypeStateIssuer
088861300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100204000075 MD Practitioner - Radiation Oncology 9931242583 Reassigns benefits to 3 organizations
I20250423002292 SC Practitioner - Radiation Oncology 9931242583 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Indiana University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

7 Richland Medical Park Dr
Suite 104
Columbia, SC 29203-6863
Phone (803) 434-6105

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0036644MDMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jun 2, 2025 Accepting new patients
Maryland Proton Treatment Center, LLC CurrentSince Oct 1, 2020 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Jun 2, 2025 Accepting new patients
Prisma Health University Medical Group CurrentSince Jun 2, 2025 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Oct 1, 2020 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Oct 1, 2020 Accepting new patients
University of Maryland Radiation Oncology Associates PA Radiation Oncology CurrentSince Oct 1, 2020 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Jun 2, 2025 Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

850 W Baltimore St
Baltimore, MD 21201
Phone (410) 227-7434

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

509 Idlewild Ave
Easton, MD 21601
Phone (410) 820-6411

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

7 Richland Medical Park Dr
Ste 104
Columbia, SC 29203
Phone (803) 434-6105

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

900 W Faris Rd
Greenville, SC 29605
Phone (864) 455-6743

Interoperability endpoints

  • Direct secure messaging: jmastandrea851258@direct.ghs.myhfn.org

Organizations & group practices 9

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1518999697",
    "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": "410-924-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 IDLEWILD AVE",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216013825",
            "telephone_number": "410-820-6411",
            "fax_number": "410-820-4229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Richland Medical Park Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036863",
            "country_code": "US",
            "telephone_number": "803-434-6105",
            "fax_number": "803-567-8946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTANDREA",
        "first_name": "JOHN",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "SC",
            "license": "83159",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_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": []
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.