Individual provider Active NPI

Mark Joseph Broering Jr., MD

  • Vascular Surgery Physician
  • Montgomery, OH
National Provider Identifier
1467714824
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
35.130473 Issued in OH
Practice address
10506A Montgomery Rd
Montgomery, OH 45242-4402
Phone
(513) 865-9898
Fax
(513) 865-9900
NPI assigned
Jun 12, 2012
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35.130473 OH
Vascular Surgery Physician 2086S0129X 35.130473 OH Primary

Addresses

Primary practice location

10506A Montgomery Rd
Montgomery, OH 45242-4402

Mailing address

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 862-3562

Other practice location 1

10506 Montgomery Rd
Montgomery, OH 45242-4487
Phone (513) 794-1601

Other practice location 2

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 862-3562

Other identifiers 1

IdentifierTypeStateIssuer
2565399MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170714000401 OH Practitioner - Vascular SurgeryPractitioner - General Surgery 0941570568 Reassigns benefits to 2 organizations
I20220902000385 KY Practitioner - Vascular Surgery 0941570568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
University of Kentucky College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trihealth H LLCGroup PAC ID 1850570458, 850 clinicians

Practice addresses (Care Compare)

100 Arrow Springs Blvd
Lebanon, OH 45036-7002
Phone (513) 793-2654

10500 Montgomery Rd
Montgomery, OH 45242-4402
Phone (513) 246-2400

10506 A Montgomery Rd
Montgomery, OH 45242-4402

10506 Montgomery Rd
Montgomery, OH 45242-4400

110 N Poplar St
Oxford, OH 45056-1204

1275 N High St
Hillsboro, OH 45133-8273
Phone (513) 246-2400

3055 Hamilton Mason Rd
Fairfield Township, OH 45011-5307

3075 Hamilton Mason Rd
Fairfield Township, OH 45011-8532
Phone (513) 246-2400

3219 Clifton Ave
Suite 215
Cincinnati, OH 45220-3042
Phone (513) 853-9000

375 Dixmyth Ave
Cincinnati, OH 45220-2475

379 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 246-7000

525 Tucker Dr
Maysville, KY 41056-9182
Phone (513) 865-9898

6949 Good Samaritan Dr
Cincinnati, OH 45247-5205

740 W Galbraith Rd
Cincinnati, OH 45231-6002

7777 Beechmont Ave
Cincinnati, OH 45255-4209

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)25
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth G, LLC CurrentSince Jul 1, 2017 Accepting new patients
Trihealth G LLC Surgery CurrentSince Jul 1, 2017 Accepting new patients
Trihealth H LLC Surgery CurrentSince Nov 1, 2021 Accepting new patients
Bethesda Hospital Inc Past Accepting new patients
The Good Samaritan Hospital of Cincinnati, Ohio Past Accepting new patients
Trihealth Physician Institute Past Accepting new patients

Locations

525 Tucker Dr
Maysville, KY 41056
Phone (606) 759-0002

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

4685 Forest Ave
Cincinnati, OH 45212
Phone (513) 853-4721

9070 Winton Rd
Cincinnati, OH 45231
Phone (513) 246-2750

3035 Hamilton Mason Rd
Ste 200
Fairfield Township, OH 45011
Phone (513) 246-8037

10506 Montgomery Rd
Montgomery, OH 45242
Phone (513) 745-9800

10506B Montgomery Rd
Montgomery, OH 45242
Phone (513) 346-5170

4685 Forest Ave
Ste C
Norwood, OH 45212
Phone (513) 246-7796

Interoperability endpoints

  • Direct secure messaging: mbroering76801@direct.trihealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1467714824",
    "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": "513-862-3562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10506A MONTGOMERY RD",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452424402",
            "telephone_number": "513-865-9898",
            "fax_number": "513-865-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10506 Montgomery Rd",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "OH",
            "postal_code": "452424487",
            "country_code": "US",
            "telephone_number": "513-794-1601",
            "fax_number": "513-794-1620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "375 Dixmyth Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452202475",
            "country_code": "US",
            "telephone_number": "513-862-3562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROERING",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.130473",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35.130473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2565399",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, OH

Sources for this page

Verify at the official NPI Registry.