Individual provider Active NPI

Muhammad Tipu Rishi, MD

  • Vascular Surgery Physician
  • Kettering, OH
National Provider Identifier
1063655165
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
35.138344 Issued in OH
Practice address
3535 Southern Blvd
Kettering, OH 45429-1221
Phone
(937) 298-4331
NPI assigned
Apr 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Vascular Surgery Physician 2086S0129X 35.138344 OH Primary

Addresses

Primary practice location

3535 Southern Blvd
Kettering, OH 45429-1221

Mailing address

1010 Cereal Ave Ste 207
Hamilton, OH 45013-2772
Phone (513) 867-3331

Other practice location 1

56 Franklin St
Saint Mary Hospital
Waterbury, CT 06706-1253
Phone (203) 709-6000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mrishi720031@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200724001391 OH Practitioner - Vascular Surgery 7719234897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

1010 Cereal Ave
Suite 207
Hamilton, OH 45013-2772
Phone (513) 867-3331

1391 Main St
Hamilton, OH 45013-1077
Phone (513) 867-9000

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

3737 Southern Blvd
Kettering, OH 45429-1285

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

630 Eaton Ave
Hamilton, OH 45013-2767
Phone (937) 395-8646

Hospital & facility affiliations

  • Kettering Homecare Home health agency, Kettering, OH, CCN 367778
  • Fort Hamilton Hughes Memorial Hospital Hospital, Hamilton, OH, CCN 360132
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal11
Leg revascularization (restoring blood flow)37
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Dec 29, 2022 Accepting new patients
Kettering Medical Center Past Accepting new patients

Locations

1380 NW Washington Blvd
Hamilton, OH 45013
Phone (513) 863-2800

1010 Cereal Ave
Ste 207
Hamilton, OH 45013
Phone (513) 867-3331

3737 Southern Blvd
Ste 2000
Kettering, OH 45429
Phone (937) 228-4126

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

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

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

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 6

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": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1063655165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 CEREAL AVE STE 207",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450132772",
            "telephone_number": "513-867-3331",
            "fax_number": "513-867-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-298-4331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "56 Franklin St",
            "address_2": "Saint Mary Hospital",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067061253",
            "country_code": "US",
            "telephone_number": "203-709-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RISHI",
        "first_name": "MUHAMMAD",
        "middle_name": "TIPU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-20",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35.138344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrishi720031@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "1010 Cereal Ave Ste 207",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1010 Cereal Ave Ste 207",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.