Organization Active NPI

Radiation Oncologists of Central Arizona

  • Radiation Oncology Physician
  • Phoenix, AZ
National Provider Identifier
1770736324
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
RADIATION ONCOLOGISTS OF CENTRAL ARIZONA
Practice address
4611 E. Shea Blvd
Ste 120
Phoenix, AZ 85028-4245
Phone
(602) 441-3845
Fax
(602) 464-9769
NPI assigned
Oct 28, 2008
Last updated
Jan 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Authorized official

Name
Dr. John Kresl, M.D., PH.DNPI 1366418675
Title
Management/Committee Member
Phone
(602) 441-3845

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 Primary

Addresses

Primary practice location

4611 E. Shea Blvd
Ste 120
Phoenix, AZ 85028-4245

Mailing address

4611 E. Shea Blvd
Ste 120
Phoenix, AZ 85028-4254
Phone (602) 441-3845

Other identifiers 1

IdentifierTypeStateIssuer
391486MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040624000761 AZ Part B Supplier - Clinic/Group Practice 0244216075 Receives reassigned benefits from 7 practitioners
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

4611 E Shea Blvd
Ste 120
Phoenix, AZ 85028
Phone (602) 441-3845

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453334400000",
    "number": "1770736324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 E. SHEA BLVD",
            "address_2": "STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850284254",
            "telephone_number": "602-441-3845",
            "fax_number": "602-464-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 E. SHEA BLVD",
            "address_2": "STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850284245",
            "telephone_number": "602-441-3845",
            "fax_number": "602-464-9769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIATION ONCOLOGISTS OF CENTRAL ARIZONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2016-01-21",
        "status": "A",
        "authorized_official_last_name": "KRESL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGEMENT/COMMITTEE MEMBER",
        "authorized_official_telephone_number": "602-441-3845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PH.D"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "391486",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.