Active NPI
Stewart I Adam Jr., MD
- Otolaryngology Physician
- Dayton, OH
National Provider Identifier
1225009517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 35051666
- Practice address
- 1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684 - Phone
- (937) 496-2600
- Fax
- (937) 496-2610
- NPI assigned
- Jan 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 35051666 | OH | Primary |
Addresses
Primary practice location
1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684
Mailing address
1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684
Phone (937) 496-2600
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0453520 | Other | AETNA | |
| 0581777 | Medicaid | OH | |
| D51666 | Other | HUMANA | |
| 000000004436 | Other | ANTHEM | |
| 1020041 | Other | UNITEDHEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35051666 | OH | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Ohio ENT Specialists Inc | Otolaryngology | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HDIFCD
Organizations & group practices 1
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.
-
- Otolaryngology Physician
- Dayton, OH
- NPI 1255301560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358208000000",
"number": "1225009517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1222 S PATTERSON BLVD",
"address_2": "SUITE 400",
"city": "DAYTON",
"state": "OH",
"postal_code": "454022684",
"telephone_number": "937-496-2600",
"fax_number": "937-496-2610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1222 S PATTERSON BLVD",
"address_2": "SUITE 400",
"city": "DAYTON",
"state": "OH",
"postal_code": "454022684",
"telephone_number": "937-496-2600",
"fax_number": "937-496-2610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAM",
"first_name": "STEWART",
"middle_name": "I",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-27",
"last_updated": "2013-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "OH",
"license": "35051666",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0453520",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0581777",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "D51666",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000004436",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITEDHEALTHCARE",
"identifier": "1020041",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.