Individual provider Active NPI

Leah M Avera, MD

  • Family Medicine Physician
  • Middletown, OH
National Provider Identifier
1003892399
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35075085K Issued in OH
Practice address
6147 State Route 122 Ste 200
Middletown, OH 45005-5201
Phone
(513) 261-3500
Fax
(513) 261-3509
NPI assigned
Dec 19, 2005
Last updated
Nov 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35075085K OH Primary

Addresses

Primary practice location

6147 State Route 122 Ste 200
Middletown, OH 45005-5201

Mailing address

6147 State Route 122 Ste 200
Middletown, OH 45005-5201
Phone (513) 261-3500

Other identifiers 1

IdentifierTypeStateIssuer
2089314MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lavera161476@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080417000393 OH Practitioner - Family Practice 7214015122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Cincinnati College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

1625 S Alex Rd
West Carrollton, OH 45449-5404
Phone (937) 865-0534

450 B Washington Jackson Blvd
Suite 105
Eaton, OH 45320-7601
Phone (937) 456-8350

450 B Washington Jackson Rd
Suite 108
Eaton, OH 45320-7601
Phone (937) 456-8300

6147 State Route 122
Middletown, OH 45005-5201
Phone 5132613500513261

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35075085KOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc Family Medicine CurrentSince Apr 10, 2017 Accepting new patients
Alliance Physicians Inc CurrentSince Apr 10, 2017 Accepting new patients

Locations

7740 Washington Village Dr
Ste 130
Dayton, OH 45459
Phone (513) 932-4891

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

1042 Summit Dr
Middletown, OH 45042
Phone (513) 217-5850

6147 State Route 122
Ste 200
Middletown, OH 45005
Phone (513) 261-3500

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Organizations & group practices 2

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1003892399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6147 STATE ROUTE 122 STE 200",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055201",
            "telephone_number": "513-261-3500",
            "fax_number": "513-261-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6147 STATE ROUTE 122 STE 200",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055201",
            "telephone_number": "513-261-3500",
            "fax_number": "513-261-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERA",
        "first_name": "LEAH",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35075085K",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2089314",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lavera161476@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "6147 State Route 122 Ste 200",
            "city": "Middletown",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450055201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6147 State Route 122 Ste 200",
            "city": "Middletown",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450055201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.