The Harold Leever Regional Cancer Center Inc

Key facts

NPI: 1891727657
Entity type: Organization (NPI type 2)
Primary specialty: Radiation Oncology Clinic/Center 261QX0203X
License: 0377 (CT)
Legal business name: THE HAROLD LEEVER REGIONAL CANCER CENTER INC
Practice address: 1075 Chase Pkwy
Waterbury, CT 06708-2948
Phone: (203) 575-5555
Fax: (203) 575-5562
NPI assigned: Jul 6, 2006
Organization subpart: No

Authorized official

Name: Thomas Belzek
Title: Finance Director
Phone: (203) 575-5563

Other NPIs with the same Medicare PAC ID 1

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

The Harold Leever Regional Cancer Center Inc Radiation Oncology Physician · Waterbury, CT · NPI 1235145194

Same PAC ID 5294786299

Corporate family (same tax ID) 1

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

The Harold Leever Regional Cancer Center Inc Radiation Oncology Physician · Waterbury, CT · NPI 1235145194

NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Prospect Waterbury, Inc. General Acute Care Hospital · Waterbury, CT · NPI 1477902641

NPD member Member Of

Practitioners 6

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

Andrew J Lawson, MD Diagnostic Radiology Physician · Waterbury, CT · NPI 1861459125

NPD
Michael Malin, MD Diagnostic Radiology Physician · Southbury, CT · NPI 1275565640

NPD
Marco Verga, MD Diagnostic Radiology Physician · Waterbury, CT · NPI 1689631947

NPD
Douglas Michael Housman, M.D. Radiation Oncology Physician · Bristol, CT · NPI 1760640643

NPD (past)
Meriem Mokhtech, MD Radiation Oncology Physician · Bristol, CT · NPI 1245721646

NPD (past)
Joseph Ravalese, MD Radiation Oncology Physician · Bristol, CT · NPI 1376505081

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CT

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20050309000902	CT	Part B Supplier - Independent Diagnostic Testing Facility (Idtf)	5294786299	Practice locations: Waterbury, CT

National Provider Directory

Tax ID family: Harold Leever Cancer Center (2 organizations share this tax ID)

Locations

1075 Chase Pkwy
Waterbury, CT 06708
Phone (203) 575-5555

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Radiation Oncology Clinic/Center	261QX0203X	0377	CT	Yes

Addresses

Primary practice location

1075 Chase Pkwy
Waterbury, CT 06708-2948

Mailing address

1075 Chase Pkwy
Waterbury, CT 06708-2948
Phone (203) 575-5555

Other identifiers

Identifier	Type	State	Issuer
2685544	Other	CT	AETNA
68RDONC02CT01	Other	CT	ANTHEM
4239712	Medicaid	CT

Other providers in Waterbury, CT

All providers in Waterbury, CT · Radiation Oncology Clinic/Center in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.