Organization Active NPI

Northeast Radiation Oncology Center

  • Radiation Oncology Physician
  • Dunmore, PA
National Provider Identifier
1891794467
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
NORTHEAST RADIATION ONCOLOGY CENTER
Practice address
1110 Meade St Ste 1
Dunmore, PA 18512-3169
Phone
(570) 504-7200
Fax
(570) 504-7209
NPI assigned
Jul 18, 2005
Last updated
Jan 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Dr. Christopher A Peters, M.D.NPI 1487831673
Title
Medical Director
Phone
(570) 504-7200

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 Physician 2085R0001X NU Primary

Addresses

Primary practice location

1110 Meade St Ste 1
Dunmore, PA 18512-3169

Mailing address

712 Main St
Moosic, PA 18507-1094
Phone (570) 504-7210

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041207000733 PA Part B Supplier - Clinic/Group Practice 9335105774 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Dunmore, PA

National Provider Directory

National Provider Directory

Locations

1110 Meade St
Dunmore, PA 18512
Phone (570) 504-7200

1110 Meade St
Ste 1
Dunmore, PA 18512
Phone (570) 504-7200

Practitioners & affiliated clinicians

Practitioners 11

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": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1891794467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 MAIN ST",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071094",
            "telephone_number": "570-504-7210",
            "fax_number": "570-955-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 MEADE ST STE 1",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185123169",
            "telephone_number": "570-504-7200",
            "fax_number": "570-504-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST RADIATION ONCOLOGY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "570-504-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunmore, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.