Individual provider Active NPI

Samir B Patel, MD

  • Dermatology Physician
  • Mason, OH
National Provider Identifier
1073552261
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35-081751 Issued in OH
Practice address
5298 Socialville Foster Rd
Mason, OH 45040-9302
Phone
(513) 770-4212
Fax
(513) 770-4213
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35-081751 OH Primary
Dermatopathology Physician 207ND0900X 35-081751 OH

Addresses

Primary practice location

5298 Socialville Foster Rd
Mason, OH 45040-9302

Mailing address

5298 Socialville Foster Rd
Mason, OH 45040-9302
Phone (513) 770-4212

Other identifiers 2

IdentifierTypeStateIssuer
P00072025OtherOHRAILROAD MEDICARE
2442502MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY, NH3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20040212000360 OH Practitioner - DermatologyPractitioner - Other (Physician) 7810881570 Reassigns benefits to 1 organization
I20200414001443 KY Practitioner - Dermatology 7810881570 Reassigns benefits to 1 organization
I20260403002088 NH Practitioner - Dermatology 7810881570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Cincinnati College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Dermatology Group IncGroup PAC ID 6406740141, 19 clinicians

Practice addresses (Care Compare)

330 Thomas More Pkwy
Crestview Hills, KY 41017-3417
Phone (513) 770-4212

5298 Socialville Foster Rd
Mason, OH 45040-9302
Phone (513) 770-4212

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions277
Removal or shaving of skin growth1-10
Skin biopsy142

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-081751OHMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Dermatology Group, Inc Dermatology CurrentSince Feb 1, 2004 Accepting new patients
Brett Coldiron MD Dermatology Past Accepting new patients

Locations

330 Thomas More Pkwy
Ste 201
Crestview Hills, KY 41017
Phone (853) 934-4621

330 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (513) 241-2360

9403 Kenwood Rd
Ste B100
Blue Ash, OH 45242
Phone (513) 891-8045

4450 Eastgate Blvd
Ste 232
Cincinnati, OH 45245
Phone (513) 752-2247

6507 Harrison Ave
Unit I
Cincinnati, OH 45247

4000 Smith Rd
Ste 210
Cincinnati, OH 45209

5184 Socialville Foster Rd
Mason, OH 45040
Phone (513) 770-0953

5298 Socialville Foster Rd
Mason, OH 45040
Phone (513) 770-0953

36 Remick Blvd
Springboro, OH 45066

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5662/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1073552261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5298 SOCIALVILLE FOSTER RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450409302",
            "telephone_number": "513-770-4212",
            "fax_number": "513-770-4213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5298 SOCIALVILLE FOSTER RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450409302",
            "telephone_number": "513-770-4212",
            "fax_number": "513-770-4213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SAMIR",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35-081751",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "OH",
            "license": "35-081751",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00072025",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2442502",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.