Individual provider Active NPI

Glen Papaioannou, MD

  • Medical Oncology Physician
  • Beavercreek, OH
National Provider Identifier
1275744542
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
35.085213 Issued in OH
Practice address
3535 Pentagon Blvd Ste 400
Beavercreek, OH 45431-1705
Phone
(374) 902-2649
Fax
(937) 281-3913
NPI assigned
May 25, 2007
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 35.085213 OH
Hematology & Oncology Physician 207RH0003X 01070680A IN
Medical Oncology Physician 207RX0202X 35.085213 OH Primary

Addresses

Primary practice location

3535 Pentagon Blvd Ste 400
Beavercreek, OH 45431-1705

Mailing address

3535 Pentagon Blvd Ste 400
Beavercreek, OH 45431-1705
Phone (937) 490-2264

Other identifiers 1

IdentifierTypeStateIssuer
2916321MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gpapaioannou186505@direct.ketteringhealth.org
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171030000526 OH Practitioner - Medical Oncology 8628145661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Loma Linda University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3535 Pentagon Blvd
Beavercreek, OH 45431-1705

3535 Pentagon Park Blvd
Suite 400
Dayton, OH 45431-1705
Phone (937) 490-2264

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Dec 29, 2022 Accepting new patients
Dayton Physicians, LLC Past Accepting new patients

Locations

3535 Pentagon Blvd
Ste 400
Beavercreek, OH 45431
Phone (855) 500-2873

3700 Southern Blvd
Ste 401
Kettering, OH 45429
Phone (855) 500-2873

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1275744542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 PENTAGON BLVD STE 400",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454311705",
            "telephone_number": "937-490-2264",
            "fax_number": "937-490-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 PENTAGON BLVD STE 400",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454311705",
            "telephone_number": "374-902-2649",
            "fax_number": "937-281-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPAIOANNOU",
        "first_name": "GLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35.085213",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IN",
            "license": "01070680A",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "OH",
            "license": "35.085213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2916321",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gpapaioannou186505@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3700 Southern Blvd Ste 401",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291265",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "3700 Southern Blvd Ste 401",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.