Individual provider Active NPI

Miguel M Gaeta, M.D.

  • Surgical Critical Care Physician
  • Kettering, OH
National Provider Identifier
1336306141
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
35.128427 Issued in OH
Practice address
3535 Southern Blvd
Kettering, OH 45429-1221
Phone
(937) 395-6010
Fax
(937) 395-8162
NPI assigned
May 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 241909 MA
Surgery Physician 208600000X 14547 NH
Surgery Physician 208600000X MD037557 DC
Surgical Critical Care Physician 2086S0102X 35.128427 OH Primary

Addresses

Primary practice location

3535 Southern Blvd
Kettering, OH 45429-1221

Mailing address

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-6010

Other identifiers 1

IdentifierTypeStateIssuer
0166016MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mgaeta574673@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
I20160527001826 OH Practitioner - General SurgeryPractitioner - Other (Physician) 7012063894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of California, Geffen School of Medicine, 2003
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)

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
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
  • Wayne Hospital Hospital, Greenville, OH, CCN 361335

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

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD037557DCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc Surgery CurrentSince Dec 29, 2022 Accepting new patients
Elliot Professional Services Past Accepting new patients
Kettering Medical Center Past Accepting new patients
Dayton Osteopathic Hospital Past Accepting new patients

Locations

3535 Pentagon Blvd
Ste 330
Beavercreek, OH 45431
Phone (937) 558-3021

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

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

3533 Southern Blvd
Ste 2100
Kettering, OH 45429
Phone (937) 293-3486

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

Organizations & group practices 4

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1336306141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-6010",
            "fax_number": "937-395-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-6010",
            "fax_number": "937-395-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAETA",
        "first_name": "MIGUEL",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "241909",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NH",
            "license": "14547",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DC",
            "license": "MD037557",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "OH",
            "license": "35.128427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0166016",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgaeta574673@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "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 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.