Organization Active NPI

Pioneer Valley Radiation Oncology, PC

  • Specialist
  • Springfield, MA
National Provider Identifier
1619900172
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
74050 Issued in MA
Legal business name
PIONEER VALLEY RADIATION ONCOLOGY, PC
Practice address
3350 Main St
Springfield, MA 01107-1112
Phone
(413) 794-9175
Fax
(413) 794-5153
NPI assigned
Jul 8, 2006
Last updated
Sep 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Authorized official

Name
Mr. Brian Acker, M.D.NPI 1619077369
Title
Authorized Official
Phone
(413) 794-9338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 74050 MA Primary

Addresses

Primary practice location

3350 Main St
Springfield, MA 01107-1112

Mailing address

PO Box 4110
Dept 1410
Woburn, MA 01888-4110
Phone (413) 794-9338

Other identifiers 3

IdentifierTypeStateIssuer
M20534OtherMAMEDICARE PTAN
M16963OtherMABLUE CROSS BLUE SHIELD
9783679MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040721000920 MA Part B Supplier - Clinic/Group Practice 1850371865 Receives reassigned benefits from 5 practitioners
Practice locations: Springfield, MA

National Provider Directory

National Provider Directory

Locations

3350 Main St
Springfield, MA 01107
Phone (413) 784-5437

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1619900172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4110",
            "address_2": "DEPT 1410",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018884110",
            "telephone_number": "413-794-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071112",
            "telephone_number": "413-794-9175",
            "fax_number": "413-794-5153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER VALLEY RADIATION ONCOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "ACKER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "413-794-9338",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "74050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "M20534",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "M16963",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9783679",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.