Samuel Raymond Theis, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

34.014690 Issued in OH

Practice address

4881 Sugar Maple Dr
Wright Patterson AFB, OH 45433-5529

Phone

(937) 257-1770

NPI assigned

Feb 7, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upper Valley Medical Center Hospital, Troy, OH, CCN 360174

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Premier Health Specialists Inc

  • Internal Medicine Physician
  • Moraine, OH
  • NPI 1194958223
  Medicare reassignment Care Compare group NPD
• Premier Health Specialists Inc

  dba Premier OBGyn

  • Obstetrics & Gynecology Physician
  • Springboro, OH
  • NPI 1558667261
  NPD
• Premier Health Specialists Inc

  dba Advanced Ankle and Foot Specialists

  • Foot & Ankle Surgery Podiatrist
  • Dayton, OH
  • NPI 1902211287
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Upper Valley Medical Center

  • General Acute Care Hospital
  • Troy, OH
  • NPI 1184638942
  Care Compare affiliation

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1235638081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-257-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-257-1770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 N Main St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "454151184",
            "country_code": "US",
            "telephone_number": "937-832-2425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEIS",
        "first_name": "SAMUEL",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-07",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.014690",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "34.014690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Louise Swanson, OD
• Gregory Bret Sweitzer, M.D.
• Matthew Robert Talarczyk, MD
• Bryan K Tallent, D.D.S.
• Austen Tanner, O.D.
• Dale Roger Tidaback, MD, MPH
• Ryan Timar, MD
• Jodie K Timberlake
• Carter S Tisdale, MD
• Tonya M Toche-Howard, REGISTERED NURSE

• Cardiovascular Disease Physician in Wright Patterson AFB, OH
• Providers in Wright Patterson AFB, OH by specialty
• Cardiovascular Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.