Kaili Fan, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

35086851 Issued in OH

Practice address

33 W Rahn Rd
Dayton, OH 45429-2219

Phone

(937) 433-8990

Fax

(937) 433-8691

NPI assigned

Aug 18, 2005

Last updated

Sep 4, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Infectious DiseaseAlso: Internal Medicine

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Dayton Acute Care Consultants, IncGroup PAC ID 3577452465, 116 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
• Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239

Merit-based Incentive Payment System (MIPS)

Final score

91.82 of 100Reported as group

Quality

79.31

Promoting interoperability

94

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kailifan@sdacc.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Dayton Acute Care Consultants, Inc

  • Internal Medicine Physician
  • Dayton, OH
  • NPI 1669442950

  Infectious Disease

  Medicare reassignment Care Compare group NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dayton Osteopathic Hospital

  dba Kettering Health Dayton

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Main Campus

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Miamisburg

  • General Acute Care Hospital
  • Miamisburg, OH
  • NPI 1316966518
  Care Compare affiliation

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1396737094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W RAHN RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292219",
            "telephone_number": "937-433-8990",
            "fax_number": "937-433-8691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W RAHN RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292219",
            "telephone_number": "937-433-8990",
            "fax_number": "937-433-8691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "KAILI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "112063",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OH",
            "license": "35086851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2581246",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharda Fambro
• Family First Vision Care Kentucky, LLC
• Family Matterz LTD.
• Family Orthodontics of Ohio Jim Shealy DDS LLC
• Family Wellness & Empowerment Program LLC
• Lindsey Fancett, PA-C
• Cheryl Fannin
• Sydney Fannin
• Far Hills OB GYN Inc
• Far Hills Open MRI Inc

• Infectious Disease Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Infectious Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.