NPIMap

Individual provider Active NPI

Mary Ellen Gaeke, MD

  • Hematology & Oncology Physician
  • Middletown, OH
National Provider Identifier
1134180664
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
35044786 Issued in OH
Practice address
82 N Breiel Blvd
Middletown, OH 45042-3804
Phone
(513) 422-3119
Fax
(513) 420-1848
NPI assigned
Apr 2, 2006
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 35044786 OH Primary

Addresses

Primary practice location

82 N Breiel Blvd
Middletown, OH 45042-3804

Mailing address

82 N Breiel Blvd
Middletown, OH 45042-3804
Phone (513) 422-3119

Other practice location 1

600 W Main St Ste 130
Troy, OH 45373-3384
Phone (855) 500-2873

Other practice location 2

1010 Cereal Ave Ste 300
Hamilton, OH 45013-2789
Phone (855) 500-2873

Other practice location 3

3700 Southern Blvd
Kettering, OH 45429-1265
Phone (855) 500-2873

Other practice location 4

3535 Pentagon Blvd Ste 400
Beavercreek, OH 45431-1705
Phone (855) 500-2873

Other identifiers 2

IdentifierTypeStateIssuer
0428424MedicaidOH
203767807OtherOHTAX ID

Other names 1

  • Mary Ellen Broadstone Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000148 OH Practitioner - Hematology/OncologyPractitioner - Medical Oncology 1951315217 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Medical Oncology
Education
University of Chicago, Pritzker School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

3535 Pentagon Blvd
Suite 400
Beavercreek, OH 45431-1705
Phone (937) 490-2264

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35044786OHMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jun 1, 2016 Accepting new patients
Mercy Health Physicians Lima Specialty Care LLC CurrentSince Jul 1, 2022 Accepting new patients
Ohiohealth Corporation Hematology & Oncology CurrentSince Jun 1, 2016 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Oct 14, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Audiology Services Company USA, LLC Past Accepting new patients
Mary Ellen Broadstone Gaeke, MD, LLC Hematology & Oncology Past Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

800 McConnell Dr
Columbus, OH 43214
Phone (614) 533-6297

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

803 W Market St
Ste 200
Lima, OH 45805
Phone (419) 222-3737

830 W High St
Ste 390
Lima, OH 45801
Phone (419) 995-4960

Interoperability endpoints

  • Direct secure messaging: mgaeke428138@ehrdirect.uhhospitals.org
  • Direct secure messaging: mgaeke9415@direct.bsmhealth.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1143936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1134180664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 N BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423804",
            "telephone_number": "513-422-3119",
            "fax_number": "513-420-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 N BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423804",
            "telephone_number": "513-422-3119",
            "fax_number": "513-420-1848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 W Main St Ste 130",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453733384",
            "country_code": "US",
            "telephone_number": "855-500-2873",
            "fax_number": "937-380-7057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 Cereal Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "OH",
            "postal_code": "450132789",
            "country_code": "US",
            "telephone_number": "855-500-2873",
            "fax_number": "937-281-3913",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3700 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291265",
            "country_code": "US",
            "telephone_number": "855-500-2873",
            "fax_number": "937-281-3913",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Pentagon Blvd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "855-500-2873",
            "fax_number": "937-490-2266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAEKE",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-02",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35044786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0428424",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "203767807",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BROADSTONE",
            "middle_name": "ELLEN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.