Individual provider Active NPI

Dylan Reid Conroy, MD

  • Radiation Oncology Physician
  • Santa Maria, CA
National Provider Identifier
1942761812
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
A191064 Issued in CA
Practice address
1325 E Church St
Santa Maria, CA 93454-5909
Phone
(805) 925-2529
NPI assigned
Mar 25, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X A191064 CA Primary

Addresses

Primary practice location

1325 E Church St
Santa Maria, CA 93454-5909

Mailing address

1325 E Church St
Santa Maria, CA 93454-5909
Phone (805) 925-2529

Other practice location 1

1213 E Ocean Ave Ste 100
Lompoc, CA 93436-7043
Phone (805) 736-8628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240717002147 CA Practitioner - Radiation Oncology 4385189000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Georgetown University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1325 E Church St
Suite 101
Santa Maria, CA 93454-5915
Phone (805) 648-5191

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Radiation Oncology Medical Group Inc Radiation Oncology CurrentSince Aug 15, 2024 Accepting new patients
Coastal Radiation Oncology Medical Group Inc Radiation Oncology CurrentSince Aug 15, 2024 Accepting new patients
Coastal Radiation Oncology Medical Group, Inc. Radiation Oncology Past Accepting new patients

Locations

1213 E Ocean Ave
Ste 100
Lompoc, CA 93436
Phone (805) 736-8628

1325 E Church St
Ste 101
Santa Maria, CA 93454
Phone (805) 648-5191

2985 Sycamore Dr
Simi Valley, CA 93065
Phone (805) 584-6611

274 Heather Ct
Templeton, CA 93465
Phone (805) 434-1859

2900 Loma Vista Rd
Ste 100
Ventura, CA 93003
Phone (805) 648-5191

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1942761812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E CHURCH ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545909",
            "telephone_number": "805-925-2529",
            "fax_number": "805-928-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E CHURCH ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545909",
            "telephone_number": "805-925-2529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1213 E Ocean Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lompoc",
            "state": "CA",
            "postal_code": "934367043",
            "country_code": "US",
            "telephone_number": "805-736-8628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONROY",
        "first_name": "DYLAN",
        "middle_name": "REID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A191064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.