Individual provider Active NPI

Kirk M Tucker, MD

  • Internal Medicine Physician
  • Dayton, OH
National Provider Identifier
1093734501
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.080892 Issued in OH
Practice address
1715 Brown St.
Dayton, OH 45409-2624
Phone
(937) 208-9010
Fax
(937) 208-9020
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35080892 OH
Internal Medicine Physician 207R00000X 35.080892 OH Primary

Addresses

Primary practice location

1715 Brown St.
Dayton, OH 45409-2624

Mailing address

1715 Brown St.
Dayton, OH 45409-2624
Phone (937) 208-9010

Other identifiers 1

IdentifierTypeStateIssuer
2336001MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adenainternalmedicine@adena.medicity.net

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
I20040319000164 OH Practitioner - Internal Medicine 3971493198 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio State University College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians

Practice addresses (Care Compare)

1715 Brown St
Dayton, OH 45409-2502

2451 Wayne Ave
Dayton, OH 45420-1893
Phone (937) 252-1831

Hospital & facility affiliations

  • Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.080892OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc Internal Medicine CurrentSince Nov 14, 2022 Accepting new patients
Adena Medical Group LLC Internal Medicine CurrentSince Feb 24, 2010 Accepting new patients
Mvhe Inc Internal Medicine CurrentSince Nov 14, 2022 Accepting new patients
Mvhe Inc Internal Medicine Past Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

4439 State Route 159
Ste 130
Chillicothe, OH 45601
Phone (740) 779-4360

272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275

4439 State Route 159
Ste 150
Chillicothe, OH 45601
Phone (740) 779-4700

1715 Brown St
Dayton, OH 45409
Phone (937) 208-6090

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

51 E Stewart St
Dayton, OH 45409
Phone (937) 208-7070

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

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 2

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1093734501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 BROWN ST.",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092624",
            "telephone_number": "937-208-9010",
            "fax_number": "937-208-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 BROWN ST.",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092624",
            "telephone_number": "937-208-9010",
            "fax_number": "937-208-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KIRK",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35080892",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.080892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2336001",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adenainternalmedicine@adena.medicity.net",
            "affiliation": "N",
            "address_1": "4439 State Route 159 Ste 150",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456017833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.