Brian W Ondulick, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

34-00-7860-O Issued in OH

Practice address

3535 Pentagon Blvd
Suite 320
Beavercreek, OH 45431-1705

Phone

(937) 490-2270

Fax

(937) 490-2272

NPI assigned

Jan 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bondulick1104403@direct.osumc.edu

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.

• JTDM Family Practice LLC

  • Family Medicine Physician
  • St Marys, OH
  • NPI 1184652539

  OH, Surgery

  Medicare reassignment Care Compare group NPD
• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865

  OH, Surgery

  Medicare reassignment Care Compare group NPD
• Clinton County Surgical Associates, LLC

  • Surgery Physician
  • Wilmington, OH
  • NPI 1902866585

  Surgery

  NPD (past) Authorized official
• JTDM Family Practice LLC

  • Durable Medical Equipment & Medical Supplies
  • Celina, OH
  • NPI 1932670023
  Care Compare group
• Beavercreek Medical Center

  • General Acute Care Hospital
  • Beavercreek, OH
  • NPI 1760764849
  NPD (past)
• Joint Township District Memorial Hospital

  • General Acute Care Hospital
  • Saint Marys, OH
  • NPI 1639133002
  NPD (past)

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

• Beavercreek Medical Center

  • General Acute Care Hospital
  • Beavercreek, OH
  • NPI 1760764849

  Hospital

  Care Compare affiliation
• Dayton Osteopathic Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507

  Hospital

  Care Compare affiliation
• Greene Memorial Hospital Inc

  • General Acute Care Hospital
  • Xenia, OH
  • NPI 1255317848

  Hospital

  Care Compare affiliation
• Joint Township District Memorial Hospital

  • General Acute Care Hospital
  • Saint Marys, OH
  • NPI 1639133002

  Hospital

  Care Compare affiliation
• Kettering Medical Center

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984

  Hospital

  Care Compare affiliation

Specialty

General Surgery

Education

Philadelphia College of Osteopathic Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kettering Independent Medical Group Inc 699 clinicians

JTDM Family Practice LLC 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Kettering Health Greene Memorial Hospital, Xenia, OH, CCN 360026
• Grand Lake Health System Hospital, Saint Marys, OH, CCN 360032
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079

Merit-based Incentive Payment System (MIPS)

Final score

85.44 of 100Reported as group

Quality

78

Promoting interoperability

96

Improvement activities

40

Cost

76.79

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

Procedures performed for Medicare patients

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1336129485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 PENTAGON BLVD",
            "address_2": "SUITE 320",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454311705",
            "telephone_number": "937-490-2270",
            "fax_number": "937-490-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 PENTAGON BLVD",
            "address_2": "SUITE 320",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454311705",
            "telephone_number": "937-490-2270",
            "fax_number": "937-490-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONDULICK",
        "first_name": "BRIAN",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34-00-7860-O",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2495787",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bondulick185187@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3535 Pentagon Blvd",
            "address_2": "Suite 320",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454311705",
            "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": "3535 Pentagon Blvd",
            "address_2": "Suite 320",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454311705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Beavercreek, OH
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.