NPIMap

Organization Active NPI

Virginia Cancer Institute Incorporated

Doing business as VCI Harbourside CT

  • Physiological Laboratory
  • Midlothian, VA
National Provider Identifier
1851863815
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
VIRGINIA CANCER INSTITUTE INCORPORATED
Doing business as
VCI Harbourside CT
Practice address
6130 Harbourside Centre Loop
Suite 101
Midlothian, VA 23112-2170
Phone
(804) 378-0394
Fax
(804) 739-7649
NPI assigned
Dec 31, 2018
Last updated
Apr 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Authorized official

Name
Pablo M Gonzalez, MDNPI 1124080759
Title
President/Managing Partner
Phone
(804) 330-7990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X NU
Diagnostic Radiology Physician 2085R0202X NU
Physiological Laboratory 293D00000X NU Primary

Addresses

Primary practice location

6130 Harbourside Centre Loop
Suite 101
Midlothian, VA 23112-2170

Mailing address

7202 Glen Forest Dr Ste 200
Richmond, VA 23226-3780
Phone (804) 391-4171

Other names 1

  • VCI Harbourside CT Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190403002849 VA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8628048378 1 other NPI on this enrollment
Practice locations: Midlothian, VA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Virginia Cancer Institute5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618444800000",
    "number": "1851863815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7202 GLEN FOREST DR STE 200",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263780",
            "telephone_number": "804-391-4171",
            "fax_number": "804-200-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 HARBOURSIDE CENTRE LOOP",
            "address_2": "SUITE 101",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122170",
            "telephone_number": "804-378-0394",
            "fax_number": "804-739-7649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA CANCER INSTITUTE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-31",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "PABLO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/MANAGING PARTNER",
        "authorized_official_telephone_number": "804-330-7990",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VCI Harbourside CT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.