NPIMap

Individual provider Active NPI

Thomas D Fogel, MD

  • Radiation Oncology Physician
  • Ventura, CA
National Provider Identifier
1619969524
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
G54921 Issued in CA
Practice address
2900 Loma Vista Rd
Ste 100
Ventura, CA 93003-2920
Phone
(805) 648-5191
Fax
(805) 648-3458
NPI assigned
Aug 17, 2005
Last updated
Aug 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X G54921 CA Primary

Addresses

Primary practice location

2900 Loma Vista Rd
Ste 100
Ventura, CA 93003-2920

Mailing address

2900 Loma Vista Rd Ste 100
Ventura, CA 93003-2909
Phone (805) 648-5191

Other practice location 1

1213 E Ocean Ave
Lompoc, CA 93436-7041
Phone (805) 736-8628

Other identifiers 2

IdentifierTypeStateIssuer
1619969524MedicaidCA
00G549210MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20060502000762 CA Practitioner - Radiation Oncology 8921017914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Albany Medical College of Union University, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

274 Heather CT
Templeton, CA 93465-9738
Phone (805) 434-1859

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G54921CAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Radiation Oncology Medical Group Inc Radiation Oncology CurrentSince Feb 17, 2006 Accepting new patients
Coastal Radiation Oncology Medical Group, Inc. Radiation Oncology Past Accepting new patients
Community Memorial Health System Past Accepting new patients
County of Ventura Past Accepting new patients

Locations

100 Casa St
Ste C
Sn Luis Obisp, CA 93405
Phone (805) 541-1932

274 Heather Ct
Templeton, CA 93465
Phone (805) 434-1859

2900 Loma Vista Rd
Ste 100
Ventura, CA 93003
Phone (805) 648-5191

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: tfogel@croradiation.direct.varian.com

Organizations & group practices 5

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 10

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1619969524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 LOMA VISTA RD STE 100",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032909",
            "telephone_number": "805-648-5191",
            "fax_number": "805-648-3458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 LOMA VISTA RD",
            "address_2": "STE 100",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032920",
            "telephone_number": "805-648-5191",
            "fax_number": "805-648-3458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1213 E Ocean Ave",
            "address_purpose": "LOCATION",
            "city": "Lompoc",
            "state": "CA",
            "postal_code": "934367041",
            "country_code": "US",
            "telephone_number": "805-736-8628",
            "fax_number": "805-736-8785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOGEL",
        "first_name": "THOMAS",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "G54921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619969524",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G549210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.