Individual provider Active NPI

Sunita V. Dheenan, M.D.

  • Nephrology Physician
  • Kings Mills, OH
National Provider Identifier
1306021324
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35-065562 Issued in OH
Practice address
1992 King Ave
Kings Mills, OH 45034-8000
Phone
(513) 708-0906
Fax
(513) 469-2913
NPI assigned
Jan 9, 2008
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35-065562 OH Primary

Addresses

Primary practice location

1992 King Ave
Kings Mills, OH 45034-8000

Mailing address

8556 Twilight Tear LN
Cincinnati, OH 45249-1375
Phone (513) 708-0906

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
I20110712000037 OH Practitioner - Nephrology 9739263708 Practice locations: Cincinnati, OH

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Ohio State University College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12065 Montgomery Rd
Cincinnati, OH 45249-1728
Phone (513) 708-0906

8556 Twilight Tear LN
Cincinnati, OH 45249-1375

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-065562OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Internal Medicine Associates, Inc. Nephrology Past Accepting new patients

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.

Hospital & facility affiliations 2

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": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1306021324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8556 TWILIGHT TEAR LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452491375",
            "telephone_number": "513-708-0906",
            "fax_number": "513-469-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1992 KING AVE",
            "city": "KINGS MILLS",
            "state": "OH",
            "postal_code": "450348000",
            "telephone_number": "513-708-0906",
            "fax_number": "513-469-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHEENAN",
        "first_name": "SUNITA",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35-065562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Mills, OH

Sources for this page

Verify at the official NPI Registry.