| Dr Nicklas B Oldenburg, MD | |
|
825 N Main St, Providence, RI 02904-5707 | |
| (401) 521-9700 | |
| (401) 751-1686 |
| Full Name | Dr Nicklas B Oldenburg |
|---|---|
| Gender | Male |
| Speciality | Radiation Oncology |
| Experience | 30 Years |
| Location | 825 N Main St, Providence, Rhode Island |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801899760 | NPI | - | NPPES |
| 920007190 | Other | RI | RR MEDICARE |
| 110000497A | Medicaid | MA | |
| 7009934 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | 10931 (Rhode Island) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Signature Healthcare Brockton Hospital | Brockton, MA | Hospital |
| The Miriam Hospital | Providence, RI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Brockton Hospital, Inc. | 4082504733 | 42 |
| Brockton Radiation Oncology | 5092876573 | 4 |
| Brown Urology, Inc. | 7810254513 | 29 |
| Radiation Oncology Associates, Inc. | 9335190446 | 3 |
| Entity Name | Brockton Hospital, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063431286 PECOS PAC ID: 4082504733 Enrollment ID: O20040317000871 |
| Entity Name | Brockton Radiation Oncology |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639342595 PECOS PAC ID: 5092876573 Enrollment ID: O20081202000579 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Nicklas B Oldenburg, MD 825 N Main St, Providence, RI 02904-5707 Ph: (401) 521-9700 | Dr Nicklas B Oldenburg, MD 825 N Main St, Providence, RI 02904-5707 Ph: (401) 521-9700 |
Lars Stangenberg, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2 Dudley St, Suite 470, Providence, RI 02905 Phone: 401-553-8318 Fax: 401-868-2307 | |
Kara Lynne Leonard, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Rih Radiation Oncology, Providence, RI 02903 Phone: 401-444-8311 Fax: 401-444-5335 | |
Paul S Rava, MD, PHD Radiology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-8311 | |
Earle O Assanah, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5174 | |
Glenn A Tung, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-4000 | |
Dr. John Charles Mach, DO Radiology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-432-2500 | |
Sarah-kim Shields, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy St, Radiology, Providence, RI 02903 Phone: 401-444-2133 Fax: 401-444-5017 |