Individual provider Active NPI

Delaine Lynn Kendo, PA-C

  • Physician Assistant
  • Beavercreek, OH
National Provider Identifier
1376009167
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005904RX Issued in OH
Practice address
3371 Kemp Rd
Beavercreek, OH 45431-2514
Phone
(937) 458-4200
Fax
(937) 458-4209
NPI assigned
Feb 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.005904RX OH Primary

Addresses

Primary practice location

3371 Kemp Rd
Beavercreek, OH 45431-2514

Mailing address

1 Prestige PL Ste 550
Miamisburg, OH 45342-6115
Phone (937) 762-1310

Other practice location 1

1 Wyoming St
Dayton, OH 45409-2711
Phone (937) 208-8000

Other practice location 2

9000 N Main St
Englewood, OH 45415-1180
Phone (937) 734-6784

Other practice location 3

2400 Miami Valley Dr
Centerville, OH 45459-4774
Phone (937) 438-2400

Other names 1

  • Delaine Oda Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dkendo833450@direct.ketteringhealth.org
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190409001884 OH Practitioner - Physician Assistant 3274874896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

1028 Miamisburg Centerville Rd
Washington Township, OH 45459-6700
Phone (937) 281-6340

1625 S Alex Rd
West Carrollton, OH 45449-5404
Phone (937) 865-0534

3095 Dayton Xenia Rd
Suite 100
Beavercreek, OH 45434-4310
Phone (937) 531-7902

424 E Stroop Rd
Unit B
Ketterign, OH 45429-2843
Phone (937) 562-2300

50 N Progress Dr
Xenia, OH 45385-2666
Phone (937) 562-2280

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
73.21
Promoting interoperability
100
Improvement activities
40
Cost
76.12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.005904RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc CurrentSince Sep 1, 2022 Accepting new patients
Alliance Physicians Inc CurrentSince Sep 1, 2022 Accepting new patients
Miami Valley Hospital Past Accepting new patients

Locations

3371 Kemp Rd
Beavercreek, OH 45431
Phone (937) 320-3600

7740 Washington Village Dr
Ste 130
Dayton, OH 45459
Phone (513) 932-4891

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

101 E Alex Bell Rd
Ste 190
Dayton, OH 45459
Phone (937) 425-4020

3095 Dayton Xenia Rd
Ste 100
Dayton, OH 45434
Phone (937) 531-7902

424 E Stroop Rd
Unit B
Kettering, OH 45429
Phone (937) 562-2300

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

825 N Main St
Ste 120
Springboro, OH 45066
Phone (937) 762-5030

1028 Miamisburg Centerville Rd
Washington Township, OH 45459
Phone (937) 281-6340

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

50 N Progress Dr
Xenia, OH 45385
Phone (937) 352-2850

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.

NPI Registry JSON

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

{
    "created_epoch": "1550275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1376009167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL STE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426115",
            "telephone_number": "937-762-1310",
            "fax_number": "937-522-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3371 KEMP RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312514",
            "telephone_number": "937-458-4200",
            "fax_number": "937-458-4209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wyoming St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092711",
            "country_code": "US",
            "telephone_number": "937-208-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9000 N Main St",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "454151180",
            "country_code": "US",
            "telephone_number": "937-734-6784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Miami Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454594774",
            "country_code": "US",
            "telephone_number": "937-438-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENDO",
        "first_name": "DELAINE",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-16",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005904RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkendo833450@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3371 Kemp Rd",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454312514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "3371 Kemp Rd",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454312514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DELAINE",
            "last_name": "ODA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.