Petoskey Radiation Oncology, PLC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

PETOSKEY RADIATION ONCOLOGY, PLC

Practice address

416 Connable Ave
Radiology Dept
Petoskey, MI 49770-2212

Phone

(231) 487-4209

Fax

(231) 487-7840

NPI assigned

Oct 14, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Thomas P Boike, MD

Title

Authorized Signer

Phone

(231) 487-4209

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Isaac Kaufman, M.D.

  • Radiation Oncology Physician
  • Traverse City, MI
  • NPI 1821230921
  Medicare reassignment Care Compare group NPD
• Pedro Zamora, M.D.

  • Radiation Oncology Physician
  • Petoskey, MI
  • NPI 1740713338
  Medicare reassignment Care Compare group NPD
• Nathan Kaufman, M.D

  • Radiation Oncology Physician
  • Brick, NJ
  • NPI 1275537144

  MI

  Medicare reassignment NPD

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1750832705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 CONNABLE AVE",
            "address_2": "RADIOLOGY DEPT",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702212",
            "telephone_number": "231-487-4209",
            "fax_number": "231-487-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 CONNABLE AVE",
            "address_2": "RADIOLOGY DEPT",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702212",
            "telephone_number": "231-487-4209",
            "fax_number": "231-487-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETOSKEY RADIATION ONCOLOGY, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "BOIKE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "AUTHORIZED SIGNER",
        "authorized_official_telephone_number": "231-487-4209",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Petoskey Hearing Aid Center
• Petoskey Opco, LLC
• Petoskey Pediatrics, PC
• Petoskey Professional Counselors, LLC
• Petoskey Psychological Health and Wellness, PLLC
• Petoskey Spine Rehab
• Petoskey Surgeons, P.C.
• Petoskey Urgent Care Billing PC
• Petoskey Urgent Care PC
• PGPT, LLC

• Radiation Oncology Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Radiation Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.