Individual provider Active NPI

Michael Bain, MD

  • Emergency Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1225032840
Registry record updated Apr 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35055516 Issued in OH
Practice address
3131 Queen City Ave
Cincinnati, OH 45238-2316
Phone
(513) 557-3333
Fax
(513) 557-3332
NPI assigned
Jun 10, 2005
Last updated
Apr 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35055516 OH Primary

Addresses

Primary practice location

3131 Queen City Ave
Cincinnati, OH 45238-2316

Mailing address

1472 Solutions Ctr
Chicago, IL 60677-1004
Phone (513) 557-3333

Other identifiers 3

IdentifierTypeStateIssuer
100328460MedicaidIN
0724970MedicaidOH
64074842MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040728001722 OH Practitioner - Emergency Medicine 2668386004 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35055516OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Qualified Emergency Specialists Inc Emergency Medicine CurrentSince Oct 1, 1988 Accepting new patients

Locations

1472 Solutions Ctr
Chicago, IL 60677

3131 Queen City Ave
Cincinnati, OH 45238
Phone (513) 557-3209

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

1618 Deerfield Rd
Lebanon, OH 45036
Phone (513) 557-3209

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

10506 Montgomery Rd
Ste 209
Montgomery, OH 45242
Phone (513) 794-1601

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209168000000",
    "number": "1225032840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1472 SOLUTIONS CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771004",
            "telephone_number": "513-557-3333",
            "fax_number": "513-557-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 QUEEN CITY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452382316",
            "telephone_number": "513-557-3333",
            "fax_number": "513-557-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2008-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35055516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100328460",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0724970",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64074842",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.