Patrick Wald (NPI# 1851634943, PAC ID# 5597905653) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is RADIATION ONCOLOGY.
| Nation Provider ID (NPI) | 1851634943 |
| PAC ID by PECOS | 5597905653 |
| Professional Enrollment ID | I20180802002204 |
| Full Name | Patrick Wald |
| Organization Legal Name | RIVERSIDE RADIATION ONCOLOGY INC |
| Address |
1451 Yauger Rd Mount Vernon OH 43050-8097 |
| Phone Number | 7403935501 |
| Gender | M |
| Medical School | OHIO STATE UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | RADIATION ONCOLOGY |
| Group Practice PAC ID | 2769415215 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360006 | RIVERSIDE METHODIST HOSPITAL |
| 360040 | KNOX COMMUNITY HOSPITAL |
| 360348 | DUBLIN METHODIST HOSPITAL |
| 360017 | GRANT MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3535 Olentangy River Rd, Columbus, OH 43214-3908 | 6145665560 | RIVERSIDE RADIATION ONCOLOGY INC |
| 1451 Yauger Rd, Mount Vernon, OH 43050-8097 | 7403935501 | RIVERSIDE RADIATION ONCOLOGY INC |
| Organization Legal Name | RIVERSIDE RADIATION ONCOLOGY INC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark J Crnkovich | Radiation Oncology | Riverside Radiation Oncology Inc | 1451 Yauger Rd, Mount Vernon, OH 43050-8097 |
| Thomas J Pedrick | Radiation Oncology | Riverside Radiation Oncology Inc | 3535 Olentangy River Rd, Columbus, OH 43214-3908 |
| Praveen Dubey | Radiation Oncology | Riverside Radiation Oncology Inc | 3535 Olentangy River Rd, Columbus, OH 43214-3908 |
| Virginia M Diavolitsis | Radiation Oncology | Riverside Radiation Oncology Inc | 1451 Yauger Rd, Mount Vernon, OH 43050-8097 |
| Sana Rehman | Radiation Oncology | Riverside Radiation Oncology Inc | 3535 Olentangy River Rd, Columbus, OH 43214-3908 |
| Megan L Dehaan | Radiation Oncology | Riverside Radiation Oncology Inc | 3535 Olentangy River Rd, Columbus, OH 43214-3908 |
| Street Address |
1451 YAUGER RD |
| City | MOUNT VERNON |
| State | OH |
| Zip | 43050-8097 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark J Crnkovich | Radiation Oncology | Riverside Radiation Oncology Inc | 1451 Yauger Rd, Mount Vernon, OH 43050-8097 |
| Virginia M Diavolitsis | Radiation Oncology | Riverside Radiation Oncology Inc | 1451 Yauger Rd, Mount Vernon, OH 43050-8097 |
| Andrea K Mantell | Nurse Practitioner | Knox Community Hospital | 1451 Yauger Rd, Suite 1a, Mount Vernon, OH 43050-7098 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew R Kelling | Physical Therapy | Sportpro LLC | 781 Fairgrounds Rd, Suite A, Mount Vernon, OH 43050-1165 |
| Caleb Doup | Physical Therapy | Sportpro LLC | 781 Fairgrounds Rd, Suite A, Mount Vernon, OH 43050-1165 |
| Jason G Hughes | Physical Therapy | Sportpro LLC | 781 Fairgrounds Rd, Suite A, Mount Vernon, OH 43050-1165 |
| Zachary M Gatton | Anesthesiology | Knox Community Hospital | 1330 Coshocton Ave, Mount Vernon, OH 43050-1440 |
| Daniel L Smith | Family Practice | Knox Community Hospital | 1330 Coshocton Rd, Mount Vernon, OH 43050-1440 |
| Douglas A Wood | Emergency Medicine | Knox Emergency Services, LLC | 1330 Coshocton Ave, Mount Vernon, OH 43050-1440 |
| Tisha Farrell | Pathology | Osu Pathology Services, LLC | 1330 Coshocton Ave, Mount Vernon, OH 43050-1440 |
| Gilford S Vincent Sr. | Vascular Surgery | Knox Community Hospital | 1330 Coshocton Ave, Mount Vernon, OH 43050-1440 |
| Elizabeth Powell | Nurse Practitioner | Knox Community Hospital | 1330 Coshocton Ave, Mount Vernon, OH 43050-1440 |
| Amy R Monitello | Certified Registered Nurse Anesthetist (crna) | Knox Community Hospital | 1330 Coshocton Ave, Fl 5, Mount Vernon, OH 43050-1440 |
| Find all physicians in zip 43050 | |||
| City | MOUNT VERNON |
| Zip Code | 43050 |
| Specialty | RADIATION ONCOLOGY |
| City + Specialty | MOUNT VERNON + RADIATION ONCOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.