Organization Active NPI

Sequoia Radiation Oncology Services, Inc

  • Internal Medicine Physician
  • Visalia, CA
National Provider Identifier
1861091795
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SEQUOIA RADIATION ONCOLOGY SERVICES, INC
Practice address
4945 W Cypress Ave Ste a
Visalia, CA 93277-1592
Phone
(559) 624-3100
NPI assigned
Oct 21, 2020
Last updated
Mar 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Authorized official

Name
Tangel Chang, DO
Title
Ceo
Phone
(626) 428-2356

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4945 W Cypress Ave Ste a
Visalia, CA 93277-1592

Mailing address

2521 N Fontana St
Visalia, CA 93291-8196

Other practice location 1

1443 W 7th St
Hanford, CA 93230-4937
Phone (559) 585-7115

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address providerenrollment@kdhcd.org Kaweah Delta Health Care District

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210309002773 CA Part B Supplier - Clinic/Group Practice 8820404296 Receives reassigned benefits from 2 practitioners
Practice locations: Hanford, CA; Visalia, CA

National Provider Directory

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": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1861091795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 N FONTANA ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932918196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4945 W CYPRESS AVE STE A",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932771592",
            "telephone_number": "559-624-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1443 W 7th St",
            "address_purpose": "LOCATION",
            "city": "Hanford",
            "state": "CA",
            "postal_code": "932304937",
            "country_code": "US",
            "telephone_number": "559-585-7115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SEQUOIA RADIATION ONCOLOGY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "TANGEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-428-2356",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "providerenrollment@kdhcd.org",
            "affiliation": "Y",
            "affiliationName": "Kaweah Delta Health Care District",
            "address_1": "400 W Mineral King Ave",
            "city": "Visalia",
            "state": "CA",
            "country_code": "US",
            "postal_code": "932916237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.