NPIMap

Individual provider Active NPI

Nicole Susan Overbeck, PA

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1376724047
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.001315RX Issued in OH
Practice address
6350 Glenway Ave
Cincinnati, OH 45211-6378
Phone
(513) 347-6922
NPI assigned
Nov 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 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 50.001315RX OH Primary

Addresses

Primary practice location

6350 Glenway Ave
Cincinnati, OH 45211-6378

Mailing address

4685 Forest Ave
Cincinnati, OH 45212-3397
Phone (513) 246-1964

Other practice location 1

3825 Edwards Rd
Suite 300
Cincinnati, OH 45209-1287
Phone (513) 221-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080220000007 OH Practitioner - Physician Assistant 1759465487 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trihealth G LLCGroup PAC ID 0749222651, 294 clinicians

Practice addresses (Care Compare)

2001 Anderson Ferry Rd
Cincinnati, OH 45238-3325
Phone (513) 246-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005741NYMDClinical Psychologist
50.001315RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mayfield Clinic Inc CurrentSince Jul 1, 2015 Accepting new patients
Mayfield Clinic Inc Physician Assistant CurrentSince Jul 1, 2015 Accepting new patients
The Family Medical Group, LLC Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients
Trihealth G LLC Past Accepting new patients
Orthopaedic Consultants of Cincinnati, Inc. Past Accepting new patients

Locations

3825 Edwards Rd
Ste 300
Cincinnati, OH 45209

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

Interoperability endpoints

  • Direct secure messaging: noverbecklynch4033@direct.trihealth.com

Organizations & group practices 9

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 6

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": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1376724047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 FOREST AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452123397",
            "telephone_number": "513-246-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6350 GLENWAY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452116378",
            "telephone_number": "513-347-6922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3825 Edwards Rd",
            "address_2": "SUITE 300",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452091287",
            "country_code": "US",
            "telephone_number": "513-221-1100",
            "fax_number": "513-569-5297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OVERBECK",
        "first_name": "NICOLE",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-21",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.001315RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.