Individual provider Active NPI

Kate Grayson Meizlish, MD

  • Family Medicine Physician
  • Beavercreek, OH
National Provider Identifier
1053940924
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.151750 Issued in OH
Practice address
2145 N Fairfield Rd Ste 100
Beavercreek, OH 45431-2783
Phone
(937) 558-3900
Fax
(937) 558-3999
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.151750 OH Primary
Family Medicine Physician 207Q00000X 036.164812 IL

Addresses

Primary practice location

2145 N Fairfield Rd Ste 100
Beavercreek, OH 45431-2783

Mailing address

1 Prestige PL Ste 550
Miamisburg, OH 45342-6115
Phone (937) 762-1310

Other practice location 1

6201 Roosevelt Rd
Berwyn, IL 60402-1108
Phone (708) 386-0845

Other practice location 2

4790 Cottonville Rd
Jamestown, OH 45335-1518
Phone (937) 558-3900

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Direct Messaging Address kmeizlish920742@direct.ketteringhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, 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
I20231002003006 IL Practitioner - Family Practice 4486060142 Reassigns benefits to 1 organization
I20241001003628 OH Practitioner - Family Practice 4486060142 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Cincinnati College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

2145 N Fairfield Rd
Suite 100
Beavercreek, OH 45431-2556
Phone (937) 558-3900

Hospital & facility affiliations

  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
  • Kettering Health Greene Memorial Hospital, Xenia, OH, CCN 360026

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
73.21
Promoting interoperability
100
Improvement activities
40
Cost
76.12

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.164812ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PCC Community Wellness Center CurrentSince Jul 25, 2023 Accepting new patients
Alliance Physicians Inc Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
Kettering Independent Medical Group Inc Family Medicine CurrentSince Nov 25, 2024 Accepting new patients
PCC Community Wellness Center CurrentSince Jul 25, 2023 Accepting new patients
Beavercreek Medical Center Past Accepting new patients

Locations

6201 Roosevelt Rd
Berwyn, IL 60402
Phone (708) 386-0845

14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113

3535 Pentagon Blvd
Ste 220
Beavercreek, OH 45431
Phone (937) 429-7350

2145 N Fairfield Rd
Ste 100
Beavercreek, OH 45431
Phone (937) 558-3900

4790 Cottonville Rd
Jamestown, OH 45335
Phone (937) 675-2870

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

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

825 N Main St
Ste 220
Springboro, OH 45066
Phone (937) 762-5000

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Interoperability endpoints

  • Direct secure messaging: kmeizlish549019@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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 3

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1053940924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL STE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426115",
            "telephone_number": "937-762-1310",
            "fax_number": "937-522-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 N FAIRFIELD RD STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312783",
            "telephone_number": "937-558-3900",
            "fax_number": "937-558-3999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6201 Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604021108",
            "country_code": "US",
            "telephone_number": "708-386-0845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4790 Cottonville Rd",
            "address_purpose": "LOCATION",
            "city": "Jamestown",
            "state": "OH",
            "postal_code": "453351518",
            "country_code": "US",
            "telephone_number": "937-558-3900",
            "fax_number": "937-490-2270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEIZLISH",
        "first_name": "KATE",
        "middle_name": "GRAYSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.151750",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.164812",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "2145 N Fairfield Rd Ste 100",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454312783",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmeizlish920742@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "2145 N Fairfield Rd Ste 100",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454312783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.