OrganizationActive
Sovereign Medical Group LLC
NPI 1114216660 · Radiation Oncology Physician · Jersey City, NJ
Provider details
- NPI number
- 1114216660
- Entity type
- Organization
- Primary specialty
- Radiation Oncology PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Sovereign Medical Group LLC
- Organization subpart
- Yes
- Authorized official
- Donald Vardaro, Administrative Director(201) 880-7580
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
631 Grand Street
Suite 1-1
Jersey City, NJ 07304
Phone: (201) 880-7580
Fax: (201) 880-7585
Street-level locationGet directions
Mailing address
631 Grand Street
Jersey City, NJ 07304
Other names (DBA / former)
- Doing business as
- Jersey City Radiation Therapy LLC
Registry dates
- Enumerated
- 2011-04-06
- Last updated
- 2011-06-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.