Individual provider Active NPI

Audra Puzio, PA-C

  • Physician Assistant
  • Kettering, OH
National Provider Identifier
1457112955
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.008417RX Issued in OH
Practice address
3700 Southern Blvd Ste 300
Kettering, OH 45429-1265
Phone
(937) 395-8002
NPI assigned
Jan 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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 50.008417RX OH Primary

Addresses

Primary practice location

3700 Southern Blvd Ste 300
Kettering, OH 45429-1265

Mailing address

2520 Lysle LN
Cincinnati, OH 45212-1224
Phone (440) 994-9780

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Direct Messaging Address apuzio807075@direct.ketteringhealth.org

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
I20240326001688 OH Practitioner - Physician Assistant 7315384351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

Hospital & facility affiliations 3

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": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1457112955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 LYSLE LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452121224",
            "telephone_number": "440-994-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 SOUTHERN BLVD STE 300",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291265",
            "telephone_number": "937-395-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUZIO",
        "first_name": "AUDRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008417RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "3700 Southern Blvd Ste 300",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291265",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apuzio807075@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3700 Southern Blvd Ste 300",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.