Individual provider Active NPI

Jonathan Russell Dillman, M.D.

  • Pediatric Radiology Physician
  • Cincinnati, OH
National Provider Identifier
1063530277
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
35 125930 Issued in OH
Practice address
234 Goodman St
Radiology
Cincinnati, OH 45219-2364
Phone
(513) 584-2146
Fax
(513) 584-0431
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 48745 KY
Diagnostic Radiology Physician 2085R0202X 35 125930 OH
Pediatric Radiology Physician 2085P0229X 35 125930 OH Primary

Addresses

Primary practice location

234 Goodman St
Radiology
Cincinnati, OH 45219-2364

Mailing address

3333 Burnet Ave 5021
Cincinnati, OH 45229-3026
Phone (513) 636-4225

Other practice location 1

800 Rose St
Lexington, KY 40536-2364
Phone (859) 323-2222

Other identifiers 1

IdentifierTypeStateIssuer
4301083787OtherMIPHYSICIAN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 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
I20150708002949 OH Practitioner - Diagnostic Radiology 8527116466 Reassigns benefits to 3 organizations
I20151207002913 KY Practitioner - Diagnostic Radiology 8527116466 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Indiana University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 636-4200

3333 Burnet Ave
Cincinnati, OH 45229-3039

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48745KYMDPediatric Radiology Physician
35 125930OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC CurrentSince Nov 21, 2017 Accepting new patients
Columbus Radiology Corp Diagnostic Radiology CurrentSince Jun 1, 2018 Accepting new patients
University of Kentucky Diagnostic Radiology CurrentSince Oct 27, 2023 Accepting new patients

Locations

68 Cavalier Blvd
Florence, KY 41042
Phone (513) 475-7630

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3199 Highland Ave
Cincinnati, OH 45219
Phone (513) 475-7777

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

5575 Cheviot Rd
Cincinnati, OH 45247
Phone (513) 385-3113

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

1404 E 2nd St
Defiance, OH 43512
Phone (567) 368-1008

Organizations & group practices 4

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 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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1063530277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE 5021",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4225",
            "fax_number": "513-636-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOODMAN ST",
            "address_2": "RADIOLOGY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192364",
            "telephone_number": "513-584-2146",
            "fax_number": "513-584-0431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405362364",
            "country_code": "US",
            "telephone_number": "859-323-2222",
            "fax_number": "859-323-5090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILLMAN",
        "first_name": "JONATHAN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "KY",
            "license": "48745",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35 125930",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "OH",
            "license": "35 125930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "4301083787",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.