Individual provider Active NPI

Shamsuddin C Pracha, MD

  • Hospitalist Physician
  • Dayton, OH
National Provider Identifier
1104872779
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35.078920 Issued in OH
Practice address
8881 N Main St
Dayton, OH 45415-1333
Phone
(937) 832-5292
Fax
(937) 832-7505
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 35.078920 OH Primary

Addresses

Primary practice location

8881 N Main St
Dayton, OH 45415-1333

Mailing address

PO Box 634857
Cincinnati, OH 45263-4857
Phone (937) 832-5292

Other identifiers 1

IdentifierTypeStateIssuer
2600733MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address spracha529573@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 OH2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20051109000339 OH Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 3779525936 Reassigns benefits to 2 organizations
I20180731004199 OH Practitioner - Internal Medicine 3779525936 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians
University of Cincinnati Physicians Company LLCGroup PAC ID 2264344480, 1,474 clinicians

Practice addresses (Care Compare)

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

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

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

600 W Main St
Troy, OH 45373-3384

7750 Discovery Dr
West Chester, OH 45069-2598
Phone (513) 872-7100

Hospital & facility affiliations

  • West Chester Hospital Hospital, West Chester, OH, CCN 360354
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • University of Cincinnati Medical Center, LLC Hospital, Cincinnati, OH, CCN 360003

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
65.97
Promoting interoperability
100
Improvement activities
40
Cost
74.01

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Lung and Sleep Medicine Inc CurrentSince Aug 27, 2010 Accepting new patients
Mvhe Inc CurrentSince Mar 1, 2020 Accepting new patients
Upper Valley Professional Corporation Hospitalist CurrentSince Mar 1, 2020 Accepting new patients
Kettering Independent Medical Group Inc CurrentSince Dec 29, 2022 Accepting new patients
University of Cincinnati Physicians Company, LLC CurrentSince Jul 18, 2022 Accepting new patients
Conway Springs RHC Past Accepting new patients
West Chester Hospital LLC Past Accepting new patients

Locations

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

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

4777 E Galbraith Rd
Cincinnati, OH 45236
Phone (513) 686-3000

3000 Mack Rd
Hamilton, OH 45014
Phone (513) 870-7000

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

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

4000 Miamisburg Centerville Rd
Ste 450
Miamisburg, OH 45342
Phone (937) 439-3600

2115 Leiter Rd
Ste 300
Miamisburg, OH 45342

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

450 N Hyatt St
Ste 202
Tipp City, OH 45371
Phone (937) 667-3141

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

7750 Discovery Dr
West Chester, OH 45069
Phone (513) 298-7325

Organizations & group practices 9

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 4

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1104872779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634857",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452634857",
            "telephone_number": "937-832-5292",
            "fax_number": "937-832-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8881 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151333",
            "telephone_number": "937-832-5292",
            "fax_number": "937-832-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRACHA",
        "first_name": "SHAMSUDDIN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.078920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2600733",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spracha529573@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "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": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.