NPIMap

Individual provider Active NPI

Peter Kanistros, MD

  • Diagnostic Radiology Physician
  • Cincinnati, OH
National Provider Identifier
1386641454
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35072707K Issued in OH
Practice address
4983 Delhi Ave
Suite 6
Cincinnati, OH 45238-5380
Phone
(513) 347-7237
Fax
(513) 347-6567
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35072707K OH Primary
Nuclear Radiology Physician 2085N0904X 35072703 OH

Addresses

Primary practice location

4983 Delhi Ave
Suite 6
Cincinnati, OH 45238-5380

Mailing address

1331 N Elm St
Suite 200
Greensboro, NC 27401-6302
Phone (336) 274-9617

Other identifiers 2

IdentifierTypeStateIssuer
200938470MedicaidIN
2034622MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050525000995 PA Practitioner - Diagnostic Radiology 6901848381
I20061127000385 OH Practitioner - Diagnostic Radiology 6901848381 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wright State University Boonshoft School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35072703OHMDNuclear Radiology Physician
35072707KOHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trumbull Radiologists Inc Diagnostic Radiology CurrentSince Dec 3, 2018 Accepting new patients
Riverside Radiology and Interventional Associates Inc Diagnostic Radiology CurrentSince Mar 1, 2020 Accepting new patients
North Pittsburgh Imaging Specialists LLC Diagnostic Radiology CurrentSince Jul 1, 2018 Accepting new patients
University Hospitals Medical Group Inc Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Radiology Associates of Northern Kentucky, PLLC Diagnostic Radiology Past Accepting new patients
Central Ohio Primary Care Physicians, Inc. Past Accepting new patients

Locations

9360 River Rd
Marcy, NY 13403

810 S Main St
Akron, OH 44311
Phone (330) 593-1049

11100 Euclid Ave
Cleveland Heights, OH 44106

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

2588 State Route 5
Cortland, OH 44410
Phone (330) 841-5800

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

7623 Market St
Youngstown, OH 44512
Phone (330) 965-5100

2526 Wilmington Rd
New Castle, PA 16105
Phone (724) 658-1800

740 E State St
Sharon, PA 16146
Phone (724) 983-1980

Interoperability endpoints

  • Direct secure messaging: pkanistros30246@ehrdirect.uhhospitals.org

Organizations & group practices 6

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1386641454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 N ELM ST",
            "address_2": "SUITE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016302",
            "telephone_number": "336-274-9617",
            "fax_number": "336-482-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4983 DELHI AVE",
            "address_2": "SUITE 6",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452385380",
            "telephone_number": "513-347-7237",
            "fax_number": "513-347-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANISTROS",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35072707K",
            "primary": true
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "OH",
            "license": "35072703",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200938470",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2034622",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.