Orthocincy Orthopaedics & Sports Medicine PSC
Organization Active NPI Orthopaedic Surgery Physician · Cincinnati, OH
NPI 1295353092 · NPPES record last updated Aug 26, 2022
Key facts
- NPI
- 1295353092
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE PSC
- Practice address
- 8251 Pine Rd Ste 212
Cincinnati, OH 45236-2194 - Phone
- (859) 301-2663
- Fax
- (859) 817-7848
- NPI assigned
- Jul 8, 2020
- Organization subpart
- No
Authorized official
- Name
- Joann M Reis
- Title
- Executive Officer/Manager
- Phone
- (859) 817-7070
Other NPIs with the same Medicare PAC ID 14
Corporate family (same tax ID) 16
Practitioners 164
-
Brian D Barnes, PT
-
Maggie Jane Brown, PHYSICIAN ASSISTANT
-
Faith Ann Carlisle, DPT
-
Benjamin G. Davis, DPT
-
Amy Dean, PA-C
-
Michael Thomas Dee, PA-C
-
Emily Drees, PT
-
Nicholas Early, MD
-
Kelly Fornadel, PT, DPT
-
Sarah Lynn Galbreath, CNP
-
Jessica L. Heaton, PA-C
-
Christine Marie Hendron, PT, DPT
-
Mackenzie Larin Hopper, PA-C, ATC
-
John C Linz, M.D.
-
Meg Suzann Liter, DPT
-
Dennis A Mirosh, DPT
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2253037 | Orthocincy Orthopaedics & Sports Medicine | Certificate of waiver | Feb 15, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200819003527 | OH | DME Supplier - Physician - Orthopedic/Orthopedic Surgery |
3173500196 | Practice locations: Cincinnati, OH |
National Provider Directory
- Tax ID family
- Orthocincy Orthopaedics Sports Medicine PSC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician |
207QS0010X | |||
| Internal Medicine Physician |
207R00000X | |||
| Orthopaedic Surgery Physician |
207X00000X | Yes | ||
| Orthopaedic Hand Surgery Physician |
207XS0106X | |||
| Podiatrist |
213E00000X | |||
| Physical Therapist |
225100000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Medical Physician Assistant |
363AM0700X | |||
| Nurse Practitioner |
363L00000X | |||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
8251 Pine Rd Ste 212
Cincinnati, OH 45236-2194
Mailing address
560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100147130 | Other | KY | MEDICAID PHYSICAL THERAPIST |
| 7100185740 | Other | KY | MEDICAID NURSE PRACTITIONER |
| 80900186 | Other | KY | MEDICAID PODIATRIST |
| 65927881 | Medicaid | KY | |
| 9590071800 | Other | KY | MEDICAID PHYSICIAN ASSISTANT |
Other providers in Cincinnati, OH
- Sharen E Orso
- Jessica Ortega
- Carolyn Jane Orth
- Kristina Lynne Orthober
- Orthocincy Orthopaedics & Sports Medicine PSC
- Orthocincy Orthopaedics & Sports Medicine PSC
- Orthocincy Orthopaedics & Sports Medicine PSC
- Orthocincy Orthopaedics & Sports Medicine PSC
- Ortholive Medical Group Prof Corp
- Orthopaedic Consultants of Cincinnati Inc
All providers in Cincinnati, OH · Orthopaedic Surgery Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.