Individual provider Active NPI

Harmar D. Brereton, M.D.

  • Radiation Oncology Physician
  • Dunmore, PA
National Provider Identifier
1972507648
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD027996E Issued in PA
Practice address
1110 Meade St
Dunmore, PA 18512-3169
Phone
(570) 504-7200
Fax
(570) 504-7209
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD027996-E PA
Radiation Oncology Physician 2085R0001X MD027996E PA Primary
Therapeutic Radiology Physician 2085R0203X MD 027996E PA

Addresses

Primary practice location

1110 Meade St
Dunmore, PA 18512-3169

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
1155655MedicaidNY
000878796MedicaidPA
5189101MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD027996-EPAMDSpecialist
MD 027996EPAMDTherapeutic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiation Medicine Associates of Upper Delaware Valley Specialist PastSince May 4, 2011 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1972507648",
    "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",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185123169",
            "telephone_number": "570-504-7200",
            "fax_number": "570-504-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRERETON",
        "first_name": "HARMAR",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD027996-E",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "PA",
            "license": "MD027996E",
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "PA",
            "license": "MD 027996E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1155655",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000878796",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5189101",
            "state": "NJ"
        }
    ],
    "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 Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.