NPIMap

Individual provider Active NPI

Molly A Tatum, D.O.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Dayton, OH
National Provider Identifier
1043597404
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
34.012776 Issued in OH
Practice address
3205 Woodman Dr
Dayton, OH 45420-1143
Phone
(937) 298-4417
Fax
(937) 298-8260
NPI assigned
Nov 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 34.012776 OH Primary

Addresses

Primary practice location

3205 Woodman Dr
Dayton, OH 45420-1143

Mailing address

6480 Harrison Ave Ste 201
Cincinnati, OH 45247-7961
Phone (513) 713-1779

Other identifiers 1

IdentifierTypeStateIssuer
0236490MedicaidOH

Other names 1

  • Dr. Molly A McGraw Former name

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
I20170823002482 OH Practitioner - Orthopedic Surgery 9335386242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Ohio University, College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3205 Woodman Dr
Dayton, OH 45420-1143
Phone (937) 298-4417

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement16
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)23

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Orthopaedics & Sports Medicine, LTD CurrentSince Dec 30, 2022 Accepting new patients
Beacon Orthopaedics & Sports Medicine LTD Sports Medicine CurrentSince Dec 30, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

6480 Harrison Ave
Cincinnati, OH 45247
Phone (513) 251-7827

6480 Harrison Ave
Ste 201
Cincinnati, OH 45247
Phone (513) 354-7650

3205 Woodman Dr
Kettering, OH 45420
Phone (937) 298-4417

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

70 Weller Dr
Tipp City, OH 45371
Phone (937) 298-4417

Interoperability endpoints

  • Direct secure messaging: molly.tatum.p1@direct.beaconortho.nextgenshare.com

Organizations & group practices 3

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 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": "1321056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1043597404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 HARRISON AVE STE 201",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477961",
            "telephone_number": "513-713-1779",
            "fax_number": "138-549-9215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 WOODMAN DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454201143",
            "telephone_number": "937-298-4417",
            "fax_number": "937-298-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "MOLLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-12",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "OH",
            "license": "34.012776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0236490",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "MCGRAW",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.