Individual provider Active NPI

Debra L Breneman, M. D.

  • Dermatology Physician
  • Cincinnati, OH
National Provider Identifier
1124065438
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35.052109 Issued in OH
Practice address
3130 Highland Ave
Cincinnati, OH 45219-2399
Phone
(513) 584-3686
Fax
(513) 475-7636
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35.052109 OH Primary

Addresses

Primary practice location

3130 Highland Ave
Cincinnati, OH 45219-2399

Mailing address

PO Box 636256
Central Credentialing
Cincinnati, OH 45263-6256
Phone (513) 585-5502

Other identifiers 1

IdentifierTypeStateIssuer
0613732MedicaidOH

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
I20081111000005 OH Practitioner - Dermatology 8820157514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC CurrentSince Jul 1, 2016 Accepting new patients
University Dermatology Consultants, Inc Dermatology Past Accepting new patients

Locations

3199 Highland Ave
#A3
Cincinnati, OH 45219
Phone (513) 558-5102

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

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

3130 Highland Ave
Cincinnati, OH 45219
Phone (513) 584-4061

2830 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 245-3335

Interoperability endpoints

  • Direct secure messaging: dbreneman37940@direct.uchealth.com

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1124065438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256",
            "address_2": "CENTRAL CREDENTIALING",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-585-5502",
            "fax_number": "513-585-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 HIGHLAND AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192399",
            "telephone_number": "513-584-3686",
            "fax_number": "513-475-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENEMAN",
        "first_name": "DEBRA",
        "middle_name": "L",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35.052109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0613732",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.