Individual provider Active NPI

Paul Alberto Waller, M.D.

  • Family Medicine Physician
  • Mason, OH
National Provider Identifier
1154472462
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35058185 Issued in OH
Practice address
8350 Arbor Square Dr
Mason, OH 45040-5000
Phone
(513) 346-3888
Fax
(513) 229-8310
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35058185 OH Primary

Addresses

Primary practice location

8350 Arbor Square Dr
Mason, OH 45040-5000

Mailing address

8350 Arbor Square Dr
Mason, OH 45040-5000
Phone (513) 346-3888

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
I20070621000733 OH Practitioner - Family Practice 4284733866 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35058185OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth G LLC Family Medicine CurrentSince Jan 1, 2016 Accepting new patients
Trihealth H LLC CurrentSince Nov 1, 2021 Accepting new patients
Trihealth G, LLC CurrentSince Jan 1, 2016 Accepting new patients
Neighborhood Health Care, Inc. Past Accepting new patients
Doctors Urgent Care Offices Medical Group Inc PastSince Oct 1, 2003 Accepting new patients
CG Medical Associates Inc Family Medicine PastSince Dec 1, 2021 Accepting new patients
West End Health Center Inc Past Accepting new patients

Locations

425 Farrell Ct
Cincinnati, OH 45233
Phone (513) 451-6871

9070 Winton Rd
Cincinnati, OH 45231
Phone (513) 246-2750

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

4685 Forest Ave
Cincinnati, OH 45212
Phone (513) 853-4721

6139 Glenway Ave
Cincinnati, OH 45211
Phone (513) 346-3399

8350 Arbor Square Dr
Mason, OH 45040
Phone (513) 346-3399

Organizations & group practices 7

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1154472462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8350 ARBOR SQUARE DR",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450405000",
            "telephone_number": "513-346-3888",
            "fax_number": "513-229-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8350 ARBOR SQUARE DR",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450405000",
            "telephone_number": "513-346-3888",
            "fax_number": "513-229-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "PAUL",
        "middle_name": "ALBERTO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35058185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.