NPIMap

Individual provider Active NPI

Theodore S Marty III, MD

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1477517118
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35057786M Issued in OH
Practice address
1507 Springfield Pike
Cincinnati, OH 45215-1437
Phone
(513) 821-6500
Fax
(513) 821-4333
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35057786M OH Primary

Addresses

Primary practice location

1507 Springfield Pike
Cincinnati, OH 45215-1437

Mailing address

1507 Springfield Pike
Cincinnati, OH 45215-1437
Phone (513) 821-6500

Other identifiers 2

IdentifierTypeStateIssuer
0729831MedicaidOH
64939564MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080910000042 OH Practitioner - Family Practice 3678649993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1507 Springfield Pike
Cincinnati, OH 45215-1437
Phone (513) 821-6500

Hospital & facility affiliations

  • Queen City Skilled Care LLC Home health agency, Cincinnati, OH, CCN 369173
  • American Mercy Home Care, LLC Home health agency, Cincinnati, OH, CCN 367167
  • Christ Hospital Hospital, Cincinnati, OH, CCN 360163
  • University of Cincinnati Medical Center, LLC Hospital, Cincinnati, OH, CCN 360003
  • Bethesda North Hospital, Cincinnati, OH, CCN 360179
  • The Jewish Hospital-Mercy Health Hospital, Cincinnati, OH, CCN 360016
  • West Chester Hospital Hospital, West Chester, OH, CCN 360354

Merit-based Incentive Payment System (MIPS)

Final score
94.55 of 100Reported as individual
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
81.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35057786MOHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Theodore S Marty MD Inc Internal Medicine CurrentSince Jan 1, 2011 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1507 Springfield Pike
Cincinnati, OH 45215
Phone (513) 821-6500

Interoperability endpoints

  • Direct secure messaging: theodore.marty.1@15727.direct.athenahealth.com

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.

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1477517118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 SPRINGFIELD PIKE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452151437",
            "telephone_number": "513-821-6500",
            "fax_number": "513-821-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 SPRINGFIELD PIKE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452151437",
            "telephone_number": "513-821-6500",
            "fax_number": "513-821-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTY",
        "first_name": "THEODORE",
        "middle_name": "S",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35057786M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0729831",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64939564",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.