Organization Active NPI

Island Cancer Center Corporation

  • Radiation Oncology Physician
  • Tamuning, GU
National Provider Identifier
1891665352
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
ISLAND CANCER CENTER CORPORATION
Practice address
633 Gov Carlos Camacho Rd
Suite#B-1
Tamuning, GU 96913
Phone
(671) 646-3363
NPI assigned
Nov 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Authorized official

Name
Ari KaterelosNPI 1861607418
Title
Ao
Phone
(909) 475-2700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

633 Gov Carlos Camacho Rd
Suite#B-1
Tamuning, GU 96913

Mailing address

633 Gov Carlos Camacho Rd
Suite B-1
Tamuning, GU 96913
Phone (671) 646-3363

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260213001231 GU Part B Supplier - Clinic/Group Practice 8628558251 Receives reassigned benefits from 1 practitioner
Practice locations: Tamuning, GU

National Provider Directory

National Provider Directory

Locations

633 Gov Carlos G Camacho Rd
Ste 1
Tamuning, GU 96913
Phone (671) 646-3363

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1891665352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 GOV CARLOS CAMACHO RD",
            "address_2": "SUITE B-1",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-646-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 GOV CARLOS CAMACHO RD",
            "address_2": "SUITE#B-1",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-646-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND CANCER CENTER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-10",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "KATERELOS",
        "authorized_official_first_name": "ARI",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "909-475-2700"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; 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.