Individual provider Active NPI

Michael R Purdy, PA

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1386662906
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50002467 Issued in OH
Practice address
375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone
(513) 872-2536
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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 50002467 OH Primary

Addresses

Primary practice location

375 Dixmyth Ave
Cincinnati, OH 45220-2475

Mailing address

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 872-2536

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
I20080416000175 OH Practitioner - Physician Assistant 1850479841 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50002467OHMDPhysician Assistant

Organizations & group practices 1

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1386662906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 DIXMYTH AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452202475",
            "telephone_number": "513-872-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 DIXMYTH AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452202475",
            "telephone_number": "513-872-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURDY",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50002467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.