Organization Active NPI

Medical Associates of Middletown Inc

  • Gastroenterology Physician
  • Middletown, OH
National Provider Identifier
1063528438
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
MEDICAL ASSOCIATES OF MIDDLETOWN INC
Practice address
42 North Breiel Blvd
Middletown, OH 45042-3804
Phone
(513) 422-0024
Fax
(513) 422-0232
NPI assigned
Aug 21, 2006
Last updated
Jul 23, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Authorized official

Name
Dr. Richard Francis Gaeke, MD FACPNPI 1174537682
Title
President
Phone
(513) 422-0024

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

42 North Breiel Blvd
Middletown, OH 45042-3804

Mailing address

42 North Breiel Blvd
Middletown, OH 45042-3804
Phone (513) 422-0024

Other identifiers 1

IdentifierTypeStateIssuer
0815621MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070605000203 OH Part B Supplier - Clinic/Group Practice 4587762240 Receives reassigned benefits from 1 practitioner
Practice locations: Middletown, OH

National Provider Directory

National Provider Directory

Locations

42 N Breiel Blvd
Middletown, OH 45042
Phone (513) 422-0024

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1063528438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 NORTH BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423804",
            "telephone_number": "513-422-0024",
            "fax_number": "513-422-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 NORTH BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423804",
            "telephone_number": "513-422-0024",
            "fax_number": "513-422-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF MIDDLETOWN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "GAEKE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-422-0024",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD FACP"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0815621",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.