NPIMap

Organization Active NPI

Coastal Radiation Oncology Medical Group, Inc.

Doing business as Salinas Radiation Oncology Medical Center, Inc.

  • Radiation Oncology Physician
  • Salinas, CA
National Provider Identifier
1699707885
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC.
Doing business as
Salinas Radiation Oncology Medical Center, Inc.
Practice address
1069 Los Palos Dr
Salinas, CA 93901-3916
Phone
(831) 758-2724
Fax
(831) 758-1531
NPI assigned
Jul 7, 2006
Last updated
Jul 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Authorized official

Name
Dr. Jeffrey M Rodnick, M.D.NPI 1972595882
Title
President
Phone
(805) 648-5191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X NU Primary

Addresses

Primary practice location

1069 Los Palos Dr
Salinas, CA 93901-3916

Mailing address

PO Box 849697
Los Angeles, CA 90084-9697
Phone (805) 648-5191

Other identifiers 1

IdentifierTypeStateIssuer
GR00087200MedicaidCA

Other names 1

  • Salinas Radiation Oncology Medical Center, Inc. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060419000756 CA Part B Supplier - Clinic/Group Practice 7214946201 Receives reassigned benefits from 9 practitioners
Practice locations: Salinas, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Coastal Radiation Oncology Medical Group Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 15

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.

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-2",
    "last_updated_epoch": "1406678400000",
    "number": "1699707885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849697",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900849697",
            "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": "1069 LOS PALOS DR",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939013916",
            "telephone_number": "831-758-2724",
            "fax_number": "831-758-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-07-30",
        "status": "A",
        "authorized_official_last_name": "RODNICK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-648-5191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR00087200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salinas Radiation Oncology Medical Center, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salinas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.