Individual provider Active NPI

Miguel Ernesto Habeych Sanmiguel, MD

  • Clinical Neurophysiology Physician
  • Dayton, OH
National Provider Identifier
1073685376
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
35.129825 Issued in OH
Practice address
1 Childrens PLZ
Dayton, OH 45404-1815
Phone
(937) 641-4000
Fax
(937) 641-4500
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MD427693 PA
Clinical Neurophysiology Physician 2084N0600X 35.129825 OH Primary

Addresses

Primary practice location

1 Childrens PLZ
Dayton, OH 45404-1815

Mailing address

1 Childrens PLZ
Dayton, OH 45404-1815
Phone (937) 641-3000

Other practice location 1

3333 W Tech Rd
Miamisburg, OH 45342-0955
Phone (937) 641-4000

Other identifiers 1

IdentifierTypeStateIssuer
2623432MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1073685376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041815",
            "telephone_number": "937-641-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041815",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 W Tech Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HABEYCH SANMIGUEL",
        "first_name": "MIGUEL",
        "middle_name": "ERNESTO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MD427693",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "OH",
            "license": "35.129825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2623432",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.