Anil K Agarwal, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35057666A Issued in OH

Practice address

415 Byers Rd
Ste 300
Miamisburg, OH 45342-3684

Phone

(937) 866-2494

Fax

(937) 866-8494

NPI assigned

Dec 30, 2005

Last updated

Nov 13, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1447237334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BYERS RD",
            "address_2": "STE 300",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423684",
            "telephone_number": "937-866-2494",
            "fax_number": "937-866-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BYERS RD",
            "address_2": "STE 300",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423684",
            "telephone_number": "937-866-2494",
            "fax_number": "937-866-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGARWAL",
        "first_name": "ANIL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35057666A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0305682",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "AG0805512",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00708569",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "415 Byers Rd",
            "address_2": "Ste 300",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453423684",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aagarwal439450@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "415 Byers Rd",
            "address_2": "Ste 300",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453423684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Miamisburg, OH
• Providers in Miamisburg, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.