CROIX FOSSUM (M.D.) – Radiation Oncology Physician, NPI 1104351006

CROIX FOSSUM (M.D.) is a healthcare provider. based in Chula vista, California. specializing in RADIATION ONCOLOGY. They hold the professional credentials M.D.. They hold a License No. A159160 (CA). The NPI Number for CROIX FOSSUM (M.D.) is 1104351006

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
CROIX FOSSUM (M.D.)
NPI
1104351006
Phone
(619) 502-5851
Address
769 Medical Center Ct
Enumeration Date
28 April 2017
Last Update Date
18 February 2026

Doctor Profile

Medical School Name
MAYO MEDICAL SCHOOL
Secondary Phone
8589395010
Graduation Year
2017 (9 years ago)
PAC ID
0042690406
Group Practice PAC ID
2668443326
Professional Enrollment ID
I20220701002784
Address ID
CA921232701SA7901XSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness85
Years active:9State licenses:1Digital endpointsOther names

677 RADIATION ONCOLOGY in CA

Provider Addresses for CROIX FOSSUM (M.D.)

  • 769 Medical Center Ct

    Chula Vista, CA 919116602

    Phone: (619) 502-5851

    Fax: (619) 502-5865

    Type: Location

  • 5555 Grossmont Center Dr

    LA Mesa, CA 919423019

    Phone: (619) 740-4500

    Fax: (619) 740-8499

    Type: Location

  • DEPT 338 PO BOX 509015

    SAN DIEGO, CA 921509015

    Phone:

    Type: Mailing

  • 3075 HEALTH CENTER DR

    SAN DIEGO, CA 921232773

    Phone: (858) 939-5010

    Fax: (858) 939-5021

    Type: Location

  • 1884 67TH ST NW

    ROCHESTER, MN 559018822

    Phone:

    Type: Mailing

  • 50, North Medical Drive, Salt Lake City, Salt Lake County, Utah, 84113, United States

    SALT LAKE CITY, UT 841320001

    Phone: (801) 581-2121

    Type: Location

  • PO BOX 509015

    DEPT 338

    SAN DIEGO, CA 921509015

    Phone:

    Type: Mailing

  • 7901 FROST ST

    SAN DIEGO, CA 921232701

    Phone: (858) 939-5010

    Fax: (858) 939-5021

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 21 Open Payments records for all available years, with a total value of $692.

Total Amount is formed as General ($692) + Research ($0) + Ownership ($0) = $692.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: icotec Medical Inc. ($123).

Total Amount

$692

General + Research + Ownership

Payments

21

Total payment records

General Amount

$692

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-07-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220701002784IRadiation OncologyCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
77014Ct guidance for insertion of radiation therapy fields82966$0
77427Radiation treatment management, 5 treatment sessions17953$0
77300Calculation of radiation therapy dose14240$0
77334Design and construction of complex radiation treatment device7739$0
77263Complex radiation therapy planning4139$0
View full utilization report →

Insurance plans in this area (ZIP 91911)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2668443326View full group profile
NameSpecialtyState
Radiation OncologyCA
Radiation OncologyCA
Radiation OncologyFL
Radiation OncologyCA
Radiation OncologyCA
Radiation OncologyCA
-CA
Radiation OncologyCA

Reviews

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Frequently asked questions

What unique ID ties claims to CROIX FOSSUM (M.D.)?
NPI 1104351006 is assigned to CROIX FOSSUM (M.D.) under the national enumeration system.
Is CROIX FOSSUM (M.D.) currently active in the NPI registry?
CMS-published data lists CROIX FOSSUM (M.D.) as an active registrant.
What field does CROIX FOSSUM (M.D.) work in?
You can think of CROIX FOSSUM (M.D.) as practicing within Radiation Oncology Physician. Clinical services aligned with this taxonomy classification.
Where is CROIX FOSSUM (M.D.)'s primary listing?
We display Chula Vista, California because that is what the record indicates for CROIX FOSSUM (M.D.).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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