NPIMap

Individual provider Active NPI

Michael W Stava, MD

  • Diagnostic Radiology Physician
  • Cincinnati, OH
National Provider Identifier
1053527408
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35090809 Issued in OH
Practice address
10500 Montgomery Rd
Cincinnati, OH 45242-4402
Phone
(513) 513-8651
Fax
(513) 965-8091
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 33087 KY
Diagnostic Radiology Physician 2085R0202X 33087 KY
Diagnostic Radiology Physician 2085R0202X 35090809 OH Primary

Addresses

Primary practice location

10500 Montgomery Rd
Cincinnati, OH 45242-4402

Mailing address

PO Box 42468
Cincinnati, OH 45242-0468
Phone (513) 965-8041

Other identifiers 3

IdentifierTypeStateIssuer
200934940MedicaidIN
2698924MedicaidOH
64330673MedicaidKY

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
I20081119000004 OH Practitioner - Diagnostic Radiology 0648354639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Kentucky College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tristate Img (Imaging Medical Group) IncGroup PAC ID 6204732365, 45 clinicians

Practice addresses (Care Compare)

10500 Montgomery Rd
Cincinnati, OH 45242-4402
Phone (513) 862-3710

110 N Poplar St
Oxford, OH 45056-1204
Phone (513) 569-6602

3125 Hamilton Mason Rd
Fairfield Township, OH 45011-5307
Phone (513) 894-8888

3155 Glendale Milford Rd
Cincinnati, OH 45241-3134
Phone (513) 247-8800

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 865-1331

379 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 862-3710

740 W Galbraith Rd
Cincinnati, OH 45231-6002
Phone (513) 246-7000

7777 Beechmont Ave
Cincinnati, OH 45255-4209
Phone (513) 346-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35090809OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc Emergency Medicine Current Accepting new patients
Tristate Img (Imaging Medical Group) Inc CurrentSince Jun 1, 2017 Accepting new patients

Locations

299 Kings Daughters Dr
Hatton, KY 40601
Phone (502) 875-5240

308 W Maple Ave
Lancaster, KY 40444
Phone (800) 559-6614

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

911 Bypass Rd
Pikeville, KY 41501
Phone (606) 218-4530

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1053527408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42468",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452420468",
            "telephone_number": "513-965-8041",
            "fax_number": "513-965-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452424402",
            "telephone_number": "513-513-8651",
            "fax_number": "513-965-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVA",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "33087",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "33087",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35090809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200934940",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2698924",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64330673",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.