Individual provider Active NPI

John Romeo Mansueti, M.D.

  • Radiation Oncology Physician
  • Berlin, MD
National Provider Identifier
1699776955
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
0101228433 Issued in VA
Practice address
11105 Cathage Rd
Berlin, MD 21811-2131
Phone
(410) 912-4966
Fax
(410) 912-5967
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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 0101228433 VA Primary

Addresses

Primary practice location

11105 Cathage Rd
Berlin, MD 21811-2131

Mailing address

PO Box 418837
Boston, MA 02241-8837
Phone (607) 324-2340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, DE3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20120626000055 DC Practitioner - Radiation Oncology 6305001322 Reassigns benefits to 1 organization
I20120703000063 MD Practitioner - Radiation Oncology 6305001322 Reassigns benefits to 1 organization
I20200519000445 DE Practitioner - Radiation Oncology 6305001322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Radiation Medicine, PCGroup PAC ID 6204826332, 12 clinicians
Associates in Radiation Medicine of Delaware LLCGroup PAC ID 3375973837, 3 clinicians

Practice addresses (Care Compare)

100 E Carroll St
Salisbury, MD 21801-5422
Phone (888) 846-5527

11340 Pembrooke SQ
Suite 201
Waldorf, MD 20603-4808
Phone (301) 705-5802

701 Middleford Rd
Seaford, DE 19973-3600
Phone (302) 628-6344

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101228433VAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Radiation Medicine of Delaware LLC Radiation Oncology CurrentSince Apr 27, 2020 Accepting new patients
Associates in Radiation Medicine, PC Radiation Oncology CurrentSince Jul 1, 2012 Accepting new patients
Tidalhealth Specialty Care, LLC Past Accepting new patients

Locations

701 Middleford Rd
Seaford, DE 19973
Phone (302) 628-6344

11105 Cathage Rd
Berlin, MD 21811
Phone (410) 641-9962

4901 Tesla Dr
Ste Ab
Bowie, MD 20715

4831 Tesla Dr
Ste Ac
Bowie, MD 20715
Phone (301) 805-6860

30077 Business Center Dr
Charlotte Hall, MD 20622
Phone (301) 884-2508

20330 Seneca Meadows Pkwy
Ste B
Germantown, MD 20876

8116 Good Luck Rd
Ste LL5
Lanham, MD 20706
Phone (240) 542-3060

9905 Medical Center Dr
Ste 100
Rockville, MD 20850
Phone (240) 826-6297

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

2121 Medical Park Dr
Ste 4
Silver Spring, MD 20902
Phone (301) 681-4422

11340 Pembrooke Sq
Ste 201
Waldorf, MD 20603
Phone (301) 705-5802

11006 Veirs Mill Rd
Wheaton, MD 20902
Phone (240) 489-6262

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1699776955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 418837",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022418837",
            "telephone_number": "607-324-2340",
            "fax_number": "607-324-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11105 CATHAGE RD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218112131",
            "telephone_number": "410-912-4966",
            "fax_number": "410-912-5967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSUETI",
        "first_name": "JOHN",
        "middle_name": "ROMEO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "VA",
            "license": "0101228433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

Verify at the official NPI Registry.