Individual provider Active NPI

Sholabomi Bello

  • Anesthesiologist Assistant
  • Englewood, OH
National Provider Identifier
1114896552
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
428 Katy LN
Englewood, OH 45322-2304
Phone
(937) 789-3947
NPI assigned
Nov 3, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X OH Primary

Addresses

Primary practice location

428 Katy LN
Englewood, OH 45322-2304

Mailing address

428 Katy LN
Englewood, OH 45322-2304
Phone (937) 789-3947

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260407003335 OH Practitioner - Anesthesiology Assistant 5597230599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PHS Anesthesia Billing, LLCGroup PAC ID 2264958412, 241 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8000

Hospital & facility affiliations

  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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 1

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": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1114896552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 KATY LN",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222304",
            "telephone_number": "937-789-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 KATY LN",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222304",
            "telephone_number": "937-789-3947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLO",
        "first_name": "SHOLABOMI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.