Active NPI
Nancy A Cersonsky, MD
- Radiation Oncology Physician
- Oklahoma City, OK
National Provider Identifier
1578774865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 28891
- Practice address
- 5901 W Memorial Rd
Oklahoma City, OK 73142-2015 - Phone
- (057) 736-7004
- Fax
- (405) 720-3910
- NPI assigned
- May 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 28891 | OK | Primary |
| Radiation Oncology Physician | 2085R0001X | 57007866 | OH | |
| Radiation Oncology Physician | 2085R0001X | Q2524 | TX | |
| Radiation Oncology Physician | 2085R0001X | 46111 | CO |
Addresses
Primary practice location
5901 W Memorial Rd
Oklahoma City, OK 73142-2015
Mailing address
PO Box 218
Lowell, AR 72745-0218
Phone (866) 317-3801
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 021800 | Other | CO | KAISER COMMERCIAL NUMBER |
| 23484241 | Medicaid | CO | |
| 200410900A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57007866 | OH | MD | Radiation Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583107200000",
"number": "1578774865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 218",
"city": "LOWELL",
"state": "AR",
"postal_code": "727450218",
"telephone_number": "866-317-3801",
"fax_number": "512-583-2001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 W MEMORIAL RD",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731422015",
"telephone_number": "057-736-7004",
"fax_number": "405-720-3910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERSONSKY",
"first_name": "NANCY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2020-03-02",
"certification_date": "2020-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "OK",
"license": "28891",
"primary": true
},
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "OH",
"license": "57007866",
"primary": false
},
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "TX",
"license": "Q2524",
"primary": false
},
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "CO",
"license": "46111",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER COMMERCIAL NUMBER",
"identifier": "021800",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "23484241",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200410900A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.