Individual provider Active NPI

Irina Vita Sparks, MD

  • Radiation Oncology Physician
  • Goshen, IN
National Provider Identifier
1831432236
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
01080898A Issued in IN
Practice address
200 High Park Ave
Goshen, IN 46526-4810
Phone
(574) 364-2888
NPI assigned
Apr 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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 01080898A IN Primary

Addresses

Primary practice location

200 High Park Ave
Goshen, IN 46526-4810

Mailing address

200 High Park Ave
Goshen, IN 46526-4810

Other names 1

  • Irina Danilova Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address isparks@goshenhealth.direct.varian.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20180810001732 IN Practitioner - Radiation Oncology 1658690524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Medical College of Wisconsin, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goshen Health System IncGroup PAC ID 4880598572, 135 clinicians

Practice addresses (Care Compare)

200 High Park Ave
Goshen, IN 46526-4810
Phone (574) 364-2888

Hospital & facility affiliations

  • Goshen Hospital Hospital, Goshen, IN, CCN 150026

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Hospital Association Inc Current Accepting new patients
Goshen Health System Inc CurrentSince Sep 1, 2018 Accepting new patients
Goshen Health System Inc CurrentSince Sep 1, 2018 Accepting new patients

Locations

2824 Elkhart Rd
Goshen, IN 46526
Phone (574) 534-6752

200 High Park Ave
Goshen, IN 46526
Phone (219) 533-2141

Interoperability endpoints

  • Direct secure messaging: irina.sparks@goshenhealthdirect.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.

Hospital & facility affiliations 1

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": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1831432236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGH PARK AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGH PARK AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264810",
            "telephone_number": "574-364-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "IRINA",
        "middle_name": "VITA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IN",
            "license": "01080898A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "isparks@goshenhealth.direct.varian.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "200 High Park Ave",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465264810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "IRINA",
            "last_name": "DANILOVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.