Individual provider Active NPI

Mary Pamela Pfiester, PA-C

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1467621201
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.002760 Issued in OH
Practice address
3333 Burnet Ave
MLC 2017
Cincinnati, OH 45229-3026
Phone
(513) 636-4785
Fax
(513) 636-3928
NPI assigned
Feb 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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 50.002760 OH Primary

Addresses

Primary practice location

3333 Burnet Ave
MLC 2017
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Ave
MLC 2017
Cincinnati, OH 45229-3026
Phone (513) 636-4785

Other identifiers 1

IdentifierTypeStateIssuer
000000658467OtherOHANTHEM

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
I20080521000073 OH Practitioner - Physician Assistant 6901975663 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.002760OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center Physician Assistant CurrentSince Feb 1, 2022 Accepting new patients
Orthopaedic Consultants of Cincinnati, Inc. Past Accepting new patients

Locations

3441 Solutions Ctr
Chicago, IL 60677

3341 Solutions Ctr
Chicago, IL 60677

2765 Chapel Pl
Crestview Hills, KY 41017
Phone (859) 344-1900

4315 Ivy Pointe Blvd
Cincinnati, OH 45245
Phone (513) 636-0030

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

3333 Burnet Ave
#2017
Cincinnati, OH 45229
Phone (513) 636-4454

Organizations & group practices 2

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": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1467621201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "MLC 2017",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4785",
            "fax_number": "513-636-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "MLC 2017",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4785",
            "fax_number": "513-636-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFIESTER",
        "first_name": "MARY",
        "middle_name": "PAMELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-26",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000658467",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.