NPIMap

Individual provider Active NPI

Nicklas B Oldenburg, M.D.

  • Radiation Oncology Physician
  • Providence, RI
National Provider Identifier
1801899760
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD10931 Issued in RI
Practice address
825 N Main St
Providence, RI 02904-5707
Phone
(401) 521-9700
Fax
(401) 751-1686
NPI assigned
May 24, 2005
Last updated
Mar 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 205005 MA
Radiation Oncology Physician 2085R0001X MD10931 RI Primary

Addresses

Primary practice location

825 N Main St
Providence, RI 02904-5707

Mailing address

825 N Main St
Providence, RI 02904-5767
Phone (401) 521-9700

Other practice location 1

827 N Main St Ste 4
Providence, RI 02904-5751
Phone (401) 272-7799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071001000831 MA Practitioner - Radiation Oncology 2961453089 Reassigns benefits to 2 organizations
I20100824000291 RI Practitioner - Radiation Oncology 2961453089 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of North Carolina at Chapel Hill School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brockton Radiation OncologyGroup PAC ID 5092876573, 4 clinicians
Radiation Oncology Associates, Inc.Group PAC ID 9335190446, 4 clinicians
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Brown Urology, Inc.Group PAC ID 7810254513, 32 clinicians

Practice addresses (Care Compare)

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7450

825 N Main St
Providence, RI 02904-5767
Phone (401) 521-9700

827 N Main St
Suite 4
Providence, RI 02904-5751
Phone (401) 272-7799

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.15 of 100Reported as group
Quality
84.29
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brockton Hospital, Inc. CurrentSince Sep 10, 2007 Accepting new patients
Brown Urology, Inc. CurrentSince Oct 1, 2017 Accepting new patients
Brown Urology, Inc. Radiation Oncology Current Accepting new patients
Signature Healthcare Medical Group Inc Current Accepting new patients
Brockton Hospital, Inc. CurrentSince Sep 10, 2007 Accepting new patients
Brown Urology, Inc. Radiation Oncology CurrentSince Oct 1, 2017 Accepting new patients
Radiation Oncology Associates Inc Radiation Oncology CurrentSince Jul 17, 2002 Accepting new patients
Brockton Radiation Oncology Radiation Oncology CurrentSince Sep 1, 2008 Accepting new patients
Lifespan Physician Group Inc CurrentSince Jan 1, 2026 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2026 Accepting new patients

Locations

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

825 N Main St
#2
North Providence, RI 02904

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

827 N Main St
Ste 4
Providence, RI 02904
Phone (401) 276-2060

195 Collyer St
Ste 201
Providence, RI 02904
Phone (401) 421-0710

195 Collyer St
Ste 104
Providence, RI 02904
Phone (401) 276-2026

825 N Main St
Providence, RI 02904
Phone (401) 521-9700

Interoperability endpoints

  • Direct secure messaging: nicklas.oldenburg@direct.signature.masshiway.net

Organizations & group practices 11

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

Hospital & facility affiliations 6

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1801899760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045767",
            "telephone_number": "401-521-9700",
            "fax_number": "401-751-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045707",
            "telephone_number": "401-521-9700",
            "fax_number": "401-751-1686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "827 N Main St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029045751",
            "country_code": "US",
            "telephone_number": "401-272-7799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLDENBURG",
        "first_name": "NICKLAS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MA",
            "license": "205005",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "RI",
            "license": "MD10931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.