Infectious Diseases Associates Inc

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

INFECTIOUS DISEASES ASSOCIATES INC

Practice address

3533 Southern Blvd Ste 4200
Kettering, OH 45429-1272

Phone

(937) 572-7648

Fax

(937) 832-8279

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Jack Mark Bernstein, M.D.

Title

Owner

Phone

(937) 572-7648

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FFABDA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hari Momir Polenakovik, MD

  • Hospitalist Physician
  • Dayton, OH
  • NPI 1902966690

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552608000000",
    "number": "1023061207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD STE 4200",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291272",
            "telephone_number": "937-572-7648",
            "fax_number": "937-832-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD STE 4200",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291272",
            "telephone_number": "937-572-7648",
            "fax_number": "937-832-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASES ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2019-03-15",
        "status": "A",
        "authorized_official_last_name": "BERNSTEIN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-572-7648",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2232597",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Elizabeth Hurt, ATC
• Kimberly Kae Hyatt, MSED PCC CCDCI
• Christopher Ryan Hymer, APRN
• Diane F Imbrogno, M.D.
• Katie Calaway Imhof, M.D.
• Connie Ingram
• Kevin Michael Innes, CRNA, APRN
• Internal Medicine Associates, Inc
• Internal Medicine Associates, Inc.
• Internal Medicine Associates, Inc.

• Infectious Disease Physician in Kettering, OH
• Providers in Kettering, OH by specialty
• Infectious Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.