Individual provider Active NPI

Phillip K. Hall, M.D.

  • MOHS-Micrographic Surgery Physician
  • Dayton, OH
National Provider Identifier
1144248493
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
35070320H Issued in OH
Practice address
5300 Far Hills Ave.
Dayton, OH 45429-2347
Phone
(937) 433-7536
Fax
(937) 433-9612
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 35070320H OH Primary
Procedural Dermatology Physician 207NS0135X 35070320H OH

Addresses

Primary practice location

5300 Far Hills Ave.
Dayton, OH 45429-2347

Mailing address

10727 Falls Creek LN
Centerville, OH 45458-6063
Phone (937) 885-4310

Other identifiers 4

IdentifierTypeStateIssuer
0649150OtherOHAETNA
3109647743A18OtherOHANTHEM BLUE SHIELD
OC02792OtherOHNATIONWIDE
0300288OtherOHUNITED HEALTH CARE

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
I20100512000440 OH Practitioner - Micrographic Dermatologic Surgery (MDS)Practitioner - Dermatology 4183752140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Micrographic Dermatologic Surgery (MDS)Also: Dermatology
Education
Virginia Commonwealth University, School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatologists of Southwestern Ohio, LLCGroup PAC ID 7113973041, 116 clinicians

Practice addresses (Care Compare)

45 S Stanfield Rd
Troy, OH 45373-2366
Phone (937) 339-8380

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision99
Removal of skin lesions71
Removal of skin cancer1479
Removal or shaving of skin growth1-10
Skin biopsy147

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35070320HOHMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatologists of Southwestern Ohio, LLC. CurrentSince Jul 6, 1996 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

7835 Paragon Rd
Dayton, OH 45459
Phone (937) 434-2351

5300 Far Hills Ave
Dayton, OH 45429
Phone (513) 433-7536

5300 Far Hills Ave
Ste 105
Kettering, OH 45429

5300 Far Hills Ave
Ste 300
Kettering, OH 45429
Phone (937) 433-7536

45 S Stanfield Rd
Troy, OH 45373
Phone (937) 339-8380

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1144248493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10727 FALLS CREEK LN",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454586063",
            "telephone_number": "937-885-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 FAR HILLS AVE.",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292347",
            "telephone_number": "937-433-7536",
            "fax_number": "937-433-9612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "PHILLIP",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "OH",
            "license": "35070320H",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "OH",
            "license": "35070320H",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0649150",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "3109647743A18",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONWIDE",
            "identifier": "OC02792",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0300288",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.