Individual provider Active NPI

William Andrew Middendorf, PT

  • Physical Therapist
  • Cincinnati, OH
National Provider Identifier
1104008929
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11988 Issued in OH
Practice address
7575 5 Mile Rd
Cincinnati, OH 45230-4346
Phone
(513) 233-4360
Fax
(513) 233-4361
NPI assigned
Dec 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11988 OH Primary

Addresses

Primary practice location

7575 5 Mile Rd
Cincinnati, OH 45230-4346

Mailing address

7575 5 Mile Rd
Cincinnati, OH 45230-4346
Phone (513) 233-4360

Other identifiers 1

IdentifierTypeStateIssuer
0074687MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120810000143 OH Practitioner - Physical Therapist in Private Practice 8820147994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lees Rehabilitation Services IncGroup PAC ID 0345256491, 7 clinicians

Practice addresses (Care Compare)

1149 Stone Dr
Suite 500
Harrison, OH 45030-2728
Phone (513) 367-9299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11988OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Consultants of Cincinnati, Inc. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1104008929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 5 MILE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452304346",
            "telephone_number": "513-233-4360",
            "fax_number": "513-233-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 5 MILE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452304346",
            "telephone_number": "513-233-4360",
            "fax_number": "513-233-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDENDORF",
        "first_name": "WILLIAM",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-04",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "11988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074687",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.