Individual provider Active NPI

Shawn Kise

  • Acute Care Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1124435094
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
COA.16198-NP Issued in OH
Practice address
222 Piedmont Ave
Suite 4000
Cincinnati, OH 45219-4231
Phone
(513) 475-8521
NPI assigned
Jul 12, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.313227 OH
Acute Care Nurse Practitioner 363LA2100X COA.16198-NP OH Primary

Addresses

Primary practice location

222 Piedmont Ave
Suite 4000
Cincinnati, OH 45219-4231

Mailing address

PO Box 636256
Central Credentialing
Cincinnati, OH 45263-6256
Phone (513) 245-3104

Other identifiers 1

IdentifierTypeStateIssuer
0109068MedicaidOH

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140917002921 OH Practitioner - Nurse Practitioner 5991924326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Cincinnati Physicians Company LLCGroup PAC ID 2264344480, 1,474 clinicians

Practice addresses (Care Compare)

2123 Auburn Ave
Cincinnati, OH 45219-2906

3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000

7690 Discovery Dr
West Chester, OH 45069-6542
Phone (513) 475-7425

7700 University Dr
West Chester, OH 45069-2505
Phone (513) 298-7325

Hospital & facility affiliations

  • West Chester Hospital Hospital, West Chester, OH, CCN 360354
  • University of Cincinnati Medical Center, LLC Hospital, Cincinnati, OH, CCN 360003
  • Bethesda North Hospital, Cincinnati, OH, CCN 360179

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.313227OHMDRegistered Nurse
COA.16198-NPOHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC CurrentSince Sep 1, 2014 Accepting new patients

Locations

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

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

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

7675 Wellness Way
Ste 211
West Chester, OH 45069
Phone (513) 475-7561

7700 Discovery Dr
West Chester, OH 45069

7700 University Dr
West Chester, OH 45069
Phone (513) 298-3000

7675 Wellness Way
West Chester, OH 45069
Phone (513) 475-7400

7700 University Dr
Ste 3500
West Chester, OH 45069

Interoperability endpoints

  • Direct secure messaging: skise27336@direct.uchealth.com

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 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": "1405123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1124435094",
    "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": "513-245-3104",
            "fax_number": "513-585-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PIEDMONT AVE",
            "address_2": "SUITE 4000",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452194231",
            "telephone_number": "513-475-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISE",
        "first_name": "SHAWN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-12",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.313227",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "COA.16198-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0109068",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.