Individual provider Active NPI

Thomas Nienaber, MBBS

  • Neonatal-Perinatal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1164885125
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
35.145111 Issued in OH
Practice address
3333 Burnet Ave
ML 7009
Cincinnati, OH 45229-3026
Phone
(513) 636-4830
Fax
(513) 636-7868
NPI assigned
Mar 29, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080N0001X 35.145111 OH Primary
Pediatrics Physician 208000000X 35.145111 OH
Neonatal-Perinatal Medicine Physician 2080N0001X 57544 KY

Addresses

Primary practice location

3333 Burnet Ave
ML 7009
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Ave
ML 7009
Cincinnati, OH 45229-3026
Phone (513) 636-4830

Other identifiers 2

IdentifierTypeStateIssuer
35.145111MedicaidOH
57544MedicaidKY

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
I20220919000675 OH Practitioner - Pediatric Medicine 4284926676 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57544KYMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center Single Specialty CurrentSince Jul 7, 2022 Accepting new patients
Children'S Hospital Medical Center Past Accepting new patients
St Elizabeth Medical Center, Inc Past Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

3333 Burnet Ave
#7009
Cincinnati, OH 45229
Phone (513) 636-4225

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

Organizations & group practices 3

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1164885125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 7009",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4830",
            "fax_number": "513-636-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 7009",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4830",
            "fax_number": "513-636-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIENABER",
        "first_name": "THOMAS",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-29",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OH",
            "license": "35.145111",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.145111",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "57544",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35.145111",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57544",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.