Individual provider Active NPI

Victor Suva-Viola Mangona, MD

  • Radiation Oncology Physician
  • Irving, TX
National Provider Identifier
1790910412
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
Q5028 Issued in TX
Practice address
1501 W Royal LN
Irving, TX 75063-3213
Phone
(469) 513-5500
Fax
(469) 420-9600
NPI assigned
May 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301094323 MI
Radiation Oncology Physician 2085R0001X Q5028 TX Primary

Addresses

Primary practice location

1501 W Royal LN
Irving, TX 75063-3213

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

Other identifiers 6

IdentifierTypeStateIssuer
348568201MedicaidTX
348568203MedicaidTX
240726001MedicaidAR
201312910AMedicaidKS
348568202MedicaidTX
P01667436OtherTXRAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150821012978 TX Practitioner - Radiation Oncology 2668787557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Wayne State University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

1501 W Royal LN
Irving, TX 75063-3213
Phone (469) 513-5500

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as apm
Quality
67.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301094323MIMDInternal Medicine Physician
Q5028TXMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Oncology PA Radiation Oncology CurrentSince Aug 1, 2015 Accepting new patients
Texas Oncology PA Radiation Oncology CurrentSince Aug 1, 2015 Accepting new patients
Texas Oncology PA Radiation Oncology Current Accepting new patients

Locations

4201 Brown Trl
Ste 101
Colleyville, TX 76034
Phone (682) 217-2102

7777 Forest Ln
Ste C707
Dallas, TX 75230
Phone (972) 566-3000

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

6500 Harris Pkwy
Ft Worth, TX 76132
Phone (817) 263-2600

1501 W Royal Ln
Irving, TX 75063
Phone (469) 513-5500

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

Interoperability endpoints

  • Direct secure messaging: victor.mangona@txo.ikm.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1790910412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W ROYAL LN",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633213",
            "telephone_number": "469-513-5500",
            "fax_number": "469-420-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGONA",
        "first_name": "VICTOR",
        "middle_name": "SUVA-VIOLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-26",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301094323",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "Q5028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348568201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348568203",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240726001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201312910A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348568202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01667436",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.