Individual provider Active NPI

Bakkiam Subbiah, MD

  • Neurology Physician
  • Cincinnati, OH
National Provider Identifier
1033197629
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
35123625 Issued in OH
Practice address
234 Goodman St
Cincinnati, OH 45219-2364
Phone
(513) 475-8730
Fax
(513) 475-8033
NPI assigned
Jan 4, 2006
Last updated
Jan 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036049109 IL
Neurology Physician 2084N0400X 35123625 OH Primary
Neurology Physician 2084N0400X ME88557 FL
Neurology Physician 2084N0400X 19525 IA
Clinical Neurophysiology Physician 2084N0600X 036049109 IL
Clinical Neurophysiology Physician 2084N0600X 19525 IA
Clinical Neurophysiology Physician 2084N0600X 35123625 OH
Clinical Neurophysiology Physician 2084N0600X ME88557 FL

Addresses

Primary practice location

234 Goodman St
Cincinnati, OH 45219-2364

Mailing address

2830 Victory Pkwy
Cincinnati, OH 45206-1785
Phone (513) 585-6200

Other practice location 1

1400 E Boulder St Ste 700
Colorado Springs, CO 80909-5533
Phone (719) 365-7300

Other identifiers 11

IdentifierTypeStateIssuer
20068OtherIA HEALTH SOLUTIONS
050739OtherHEALTH ALLIANCE
15929OtherMIDLANDS CHOICE
8121085OtherILBCBS
036049109MedicaidIL
686137OtherFIRST HEALTH
1996108MedicaidIA
IA0151OtherIAJOHN DEERE FAMILY
20957OtherWELLMARK
IL0136OtherILJOHN DEERE FAMILY
97295OtherWELLMARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070212000486 FL Practitioner - NeurologyPractitioner - Interventional Pain ManagementPractitioner - Nephrology 8325038482 Reassigns benefits to 2 organizations
I20140708001014 OH Practitioner - Neurology 8325038482 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Physician Professional CorporationGroup PAC ID 2668406059, 143 clinicians

Practice addresses (Care Compare)

2600 6TH SWST
Canton, OH 44710-1702
Phone (330) 363-2180

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.96 of 100Reported as group
Quality
77.5
Promoting interoperability
99
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35123625OHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Medicine Services of FL, LLC Neurology CurrentSince Apr 1, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 10, 2019 Accepting new patients
Somc Medical Care Foundation, Inc. CurrentSince Feb 18, 2019 Accepting new patients
Ohio Physician Professional Corporation CurrentSince Feb 4, 2019 Accepting new patients
Somc Medical Care Foundation, Inc. Neurology CurrentSince Feb 18, 2019 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 10, 2019 Accepting new patients
Orlando Epilepsy Center Inc Neurology Past Accepting new patients
Ora Orthopedics PC Neurology Past Accepting new patients

Locations

2080 Oakley Seaver Dr
Clermont, FL 34711
Phone (352) 241-7275

1000 Mar Walt Dr
#H
Fort Walton Beach, FL 32547

201 14th St SW
Largo, FL 33770
Phone (727) 588-5222

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

200 E State St
Alliance, OH 44601
Phone (330) 596-6000

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

832 S Main St
Orrville, OH 44667
Phone (330) 456-2695

1248 Kinneys Ln
Portsmouth, OH 45662
Phone (740) 353-2131

1735 27th St
Ste B06
Portsmouth, OH 45662
Phone (740) 356-7942

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

Networks

  • Optimum HealthCare HMO Network

Organizations & group practices 8

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 1

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1033197629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061785",
            "telephone_number": "513-585-6200",
            "fax_number": "513-245-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOODMAN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192364",
            "telephone_number": "513-475-8730",
            "fax_number": "513-475-8033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 E Boulder St Ste 700",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809095533",
            "country_code": "US",
            "telephone_number": "719-365-7300",
            "fax_number": "719-365-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUBBIAH",
        "first_name": "BAKKIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036049109",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35123625",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME88557",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IA",
            "license": "19525",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "IL",
            "license": "036049109",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "IA",
            "license": "19525",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "OH",
            "license": "35123625",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "FL",
            "license": "ME88557",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA HEALTH SOLUTIONS",
            "identifier": "20068",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "050739",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "15929",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8121085",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036049109",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "686137",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1996108",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE FAMILY",
            "identifier": "IA0151",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "20957",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE FAMILY",
            "identifier": "IL0136",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "97295",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.