NPIMap

Organization Active NPI

Clincare International Center LTD

  • Internal Medicine Physician
  • Beavercreek, OH
National Provider Identifier
1174914683
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.075882 Issued in OH
Legal business name
CLINCARE INTERNATIONAL CENTER LTD
Practice address
2416 Esquire Dr
Suite B
Beavercreek, OH 45431-2573
Phone
(937) 429-2422
Fax
(937) 352-4111
NPI assigned
Feb 5, 2015
Last updated
Oct 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Authorized official

Name
Mr. Rakesh Arora, MS COMPUTER SCIENCE
Title
Director
Phone
(937) 429-2422

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU
Chiropractor 111N00000X DC.3089 OH
Anesthesiology Physician 207L00000X 35.086273 OH
Family Medicine Physician 207Q00000X 35.125600 OH
Internal Medicine Physician 207R00000X 35.100278 NU
Internal Medicine Physician 207R00000X 35.075882 OH Primary
Cardiovascular Disease Physician 207RC0000X 35.087069 OH
Nephrology Physician 207RN0300X 35.046160 NU
Obstetrics & Gynecology Physician 207V00000X 34.007858 OH
Psychiatry Physician 2084P0800X 35.075704 OH
Psychiatry Physician 2084P0800X 35.126026 OH

Addresses

Primary practice location

2416 Esquire Dr
Suite B
Beavercreek, OH 45431-2573

Mailing address

2416 Esquire Drive
Suite B
Beavercreek, OH 45431-2573
Phone (937) 429-2422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150320001882 OH Part B Supplier - Clinic/Group Practice 7416274907 Receives reassigned benefits from 16 practitioners
Practice locations: Beavercreek, OH
O20151109000278 OH Part A Provider - Home Health Agency 7416274907 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beavercreek, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174914683. Details of each certification follow.

Home health agency certification: CCN 369178

Legal name
CLINCARE INTERNATIONAL CENTER LTD
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 10, 2018
Last certification
Jan 10, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jan 26, 2015 in OH
Enrollment address
2416 Esquire Dr
Ste B
Beavercreek, OH 45431-2573

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Clincare International Center LTDCCN 369178 · All quality measures
Ownership
Proprietary
Certified
Jan 10, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

2416 Esquire Dr
Ste B
Beavercreek, OH 45431
Phone (937) 429-2422

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10693/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rakesh Arora Individual General Partnership Interest Jan 26, 2015
Operational/Managerial Control Jan 29, 2015
Darshan Singh Sehbi Individual 5% Or Greater Direct Ownership Interest Jan 1, 2018 20.47%
Corporate Director Jan 1, 2018
Daniel Lee Whitmer Individual 5% Or Greater Direct Ownership Interest Jan 1, 2018 21.32%
Avni Arora Individual 5% Or Greater Direct Ownership Interest Dec 19, 2019 27.72%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1174914683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 ESQUIRE DRIVE",
            "address_2": "SUITE B",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312573",
            "telephone_number": "937-429-2422",
            "fax_number": "937-352-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 ESQUIRE DR",
            "address_2": "SUITE B",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312573",
            "telephone_number": "937-429-2422",
            "fax_number": "937-352-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINCARE INTERNATIONAL CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-05",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "ARORA",
        "authorized_official_first_name": "RAKESH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "937-429-2422",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS COMPUTER SCIENCE"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC.3089",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35.086273",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.125600",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": "35.100278",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.075882",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.087069",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": "35.046160",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "34.007858",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.075704",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.126026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.