NPIMap

Organization Active NPI

Pediatric Associates of Fairfield, Inc

  • Pediatrics Physician
  • Fairfield, OH
National Provider Identifier
1194844746
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
208000000X Issued in OH
Legal business name
PEDIATRIC ASSOCIATES OF FAIRFIELD, INC
Practice address
5502 Dixie Hwy
Fairfield, OH 45014-4297
Phone
(513) 874-9460
Fax
(513) 874-5731
NPI assigned
Mar 28, 2007
Last updated
Apr 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Authorized official

Name
Michael A Infantino, CFO
Title
Administrator
Phone
(513) 874-9460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 208000000X OH Primary

Addresses

Primary practice location

5502 Dixie Hwy
Fairfield, OH 45014-4297

Mailing address

5502 Dixie Hwy
Fairfield, OH 45014-4297
Phone (513) 874-9460

Other identifiers 1

IdentifierTypeStateIssuer
0135348MedicaidOH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0344968Pediatric Associates of Fairfield Inc5502 Dixie Highway, Fairfield, OH 45014Certificate of waiverNov 9, 2027

National Provider Directory

National Provider Directory

Locations

188 N Brookwood Ave
Ste B
Cincinnati, OH 45263

5502 Dixie Hwy
Fairfield, OH 45014
Phone (513) 874-5868

1010 Cereal Ave
Ste 206
Hamilton, OH 45013

1100 Harrison Ave
#B
Harrison, OH 45030

1100 Harrison Ave
Ste 2
Harrison, OH 45030
Phone (513) 202-1282

5841 Snider Rd
Ste B
Mason, OH 45040

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1194844746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5502 DIXIE HWY",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450144297",
            "telephone_number": "513-874-9460",
            "fax_number": "513-874-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5502 DIXIE HWY",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450144297",
            "telephone_number": "513-874-9460",
            "fax_number": "513-874-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF FAIRFIELD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "INFANTINO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "513-874-9460",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "208000000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0135348",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.