Individual provider Active NPI

Charles Joseph Prestigiacomo, M.D.

  • Neurological Surgery Physician
  • Cincinnati, OH
National Provider Identifier
1174658272
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
35.134660 Issued in OH
Practice address
3113 Bellevue Ave
Cincinnati, OH 45219
Phone
(513) 475-8990
Fax
(513) 475-8577
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 35.134660 OH Primary
Neurological Surgery Physician 207T00000X 25MA07461000 NJ

Addresses

Primary practice location

3113 Bellevue Ave
Cincinnati, OH 45219

Mailing address

PO Box 636256
Cincinnati, OH 45263-6256
Phone (513) 585-5505

Other identifiers 1

IdentifierTypeStateIssuer
8921903MedicaidNJ

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
I20181003003387 OH Practitioner - Neurosurgery 4284663253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Columbia University College of Physicians and Surgeons, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Cincinnati Physicians Company LLCGroup PAC ID 2264344480, 1,474 clinicians

Practice addresses (Care Compare)

222 Piedmont Ave
Cincinnati, OH 45219-4231
Phone (513) 475-7855

Hospital & facility affiliations

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

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07461000NJMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC CurrentSince Aug 20, 2018 Accepting new patients
University of Cincinnati Medical Center, LLC Past Accepting new patients

Locations

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

3113 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 475-8033

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

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

Interoperability endpoints

  • Direct secure messaging: cprestigiacomo212782@direct.uchealth.com

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.

Hospital & facility affiliations 3

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1174658272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-585-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 BELLEVUE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45219",
            "telephone_number": "513-475-8990",
            "fax_number": "513-475-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTIGIACOMO",
        "first_name": "CHARLES",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OH",
            "license": "35.134660",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NJ",
            "license": "25MA07461000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8921903",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.