Individual provider Active NPI

Mark W Moronell, M.D.

  • Cardiovascular Disease Physician
  • Kettering, OH
National Provider Identifier
1306864608
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35.122658 Issued in OH
Practice address
1380 E Stroop Rd
Kettering, OH 45429
Phone
(937) 293-3486
Fax
(937) 293-3605
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35.122658 OH Primary
Cardiovascular Disease Physician 207RC0000X 4457 AK

Addresses

Primary practice location

1380 E Stroop Rd
Kettering, OH 45429

Mailing address

1380 E Stroop Rd
Kettering, OH 45429-4926
Phone (937) 293-3486

Other identifiers 3

IdentifierTypeStateIssuer
MD1321MedicaidAK
060058886OtherAKRAILROAD MEDICARE
0097860MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmoronell550877@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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
I20140204001125 OH Practitioner - Cardiovascular Disease (Cardiology) 1951200765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

1380 E Stroop Rd
Kettering, OH 45429-4926
Phone (937) 293-3486

3533 Southern Blvd
Suite 2200
Kettering, OH 45429-1264
Phone (937) 228-4126

3535 Pentagon Blvd
Beavercreek, OH 45431-1705

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

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

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

  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc Cardiovascular Disease CurrentSince Dec 29, 2022 Accepting new patients
Premier Health Specialists Inc CurrentSince Jan 27, 2014 Accepting new patients
Premier Health Specialists Inc Cardiovascular Disease CurrentSince Jan 27, 2014 Accepting new patients
Mat-Su Valley Medical Center LLC Cardiovascular Disease Past Accepting new patients
Alaska Heart Institute Past Accepting new patients

Locations

122 Wyoming St
Dayton, OH 45409
Phone (937) 438-8640

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

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

1380 E Stroop Rd
Kettering, OH 45429
Phone (937) 293-3486

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

6147 State Route 122
Ste 200
Middletown, OH 45005
Phone (513) 261-3500

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1306864608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 E STROOP RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454294926",
            "telephone_number": "937-293-3486",
            "fax_number": "937-293-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 E STROOP RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "45429",
            "telephone_number": "937-293-3486",
            "fax_number": "937-293-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORONELL",
        "first_name": "MARK",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.122658",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AK",
            "license": "4457",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD1321",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060058886",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097860",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmoronell550877@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "1380 E Stroop Rd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45429",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1380 E Stroop Rd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.