NPIMap

Individual provider Active NPI

Michael Justin, M.D.

  • Specialist
  • Cincinnati, OH
National Provider Identifier
1023196904
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35067345 Issued in OH
Practice address
1577 Goodman Ave
A
Cincinnati, OH 45224-1004
Phone
(513) 521-3600
Fax
(513) 521-6400
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35067345 OH Primary

Addresses

Primary practice location

1577 Goodman Ave
A
Cincinnati, OH 45224-1004

Mailing address

1577 Goodman Ave
A
Cincinnati, OH 45224-1004
Phone (513) 521-3600

Other practice location 1

494 Neeb Rd
Cincinnati, OH 45233-5104
Phone (513) 347-3302

Other identifiers 1

IdentifierTypeStateIssuer
2284380MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040610000382 OH Practitioner - Internal Medicine 8820071095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1977
Medicare assignment
May accept Medicare assignment
Group practices
North College Hill InternalGroup PAC ID 0547343188, 2 clinicians

Practice addresses (Care Compare)

1577 Goodman Ave
Suite a
Cincinnati, OH 45224-1044
Phone (513) 521-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35067345OHMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
North College Hill Internal CurrentSince Jan 1, 2008 Accepting new patients
Mt. Airy Gardens Rehabilitation and Care Center LLC Past Accepting new patients
Mercy Health - West Hospital LLC Past Accepting new patients
Babar and Justin Internal Medicine PastSince Mar 23, 2004 Accepting new patients

Locations

494 Neeb Rd
Cincinnati, OH 45233
Phone (513) 347-3302

1577 Goodman Ave
Ste A
Cincinnati, OH 45224
Phone (513) 521-3600

Organizations & group practices 4

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

Hospital & facility affiliations 5

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1023196904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1577 GOODMAN AVE",
            "address_2": "A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452241004",
            "telephone_number": "513-521-3600",
            "fax_number": "513-521-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 GOODMAN AVE",
            "address_2": "A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452241004",
            "telephone_number": "513-521-3600",
            "fax_number": "513-521-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "494 Neeb Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452335104",
            "country_code": "US",
            "telephone_number": "513-347-3302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUSTIN",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35067345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2284380",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.