Individual provider Active NPI

Dean J Shanley, DO

  • Diagnostic Radiology Physician
  • Cincinnati, OH
National Provider Identifier
1477552990
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
34006862S Issued in OH
Practice address
10500 Montgomery Rd
Cincinnati, OH 45242-4402
Phone
(513) 965-8041
Fax
(513) 965-8091
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 34006862S OH Primary

Addresses

Primary practice location

10500 Montgomery Rd
Cincinnati, OH 45242-4402

Mailing address

PO Box 42468
Cincinnati, OH 45242-0468
Phone (513) 965-8041

Other identifiers 2

IdentifierTypeStateIssuer
64960313MedicaidKY
2085989MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, HI, NV3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20041210000921 OH Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 7416936398 Reassigns benefits to 4 organizations
I20200206000827 HI Practitioner - Diagnostic Radiology 7416936398 Reassigns benefits to 1 organization
I20220627002526 NV Practitioner - Diagnostic Radiology 7416936398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Philadelphia College of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbus Radiology CorpGroup PAC ID 6507754983, 290 clinicians

Practice addresses (Care Compare)

1357 Kapiolani Blvd
Suite 830
Honolulu, HI 96814-4534
Phone (888) 522-4514

822 Geraldine Dr
Incline Village, NV 89451-8621
Phone (380) 235-6195

Hospital & facility affiliations

  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Fairfield Medical Center Hospital, Lancaster, OH, CCN 360072
  • Mercy Health - Fairfield Hospital Hospital, Fairfield, OH, CCN 360056
  • Mercy Health - West Hospital Hospital, Cincinnati, OH, CCN 360234

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34006862SOHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown LLC CurrentSince Mar 27, 2020 Accepting new patients
Mercy Health Physicians Youngstown, LLC Current Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Tristate Img (Imaging Medical Group) Inc CurrentSince Jun 1, 2017 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

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

107 Royal Birkdale Dr
Ste A
Columbiana, OH 44408
Phone (330) 482-9350

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

12029 Sheraton Ln
Springdale, OH 45246
Phone (513) 874-8111

1932 Niles Cortland Rd NE
Ste X
Warren, OH 44484
Phone (330) 306-5371

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1477552990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42468",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452420468",
            "telephone_number": "513-965-8041",
            "fax_number": "513-965-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452424402",
            "telephone_number": "513-965-8041",
            "fax_number": "513-965-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANLEY",
        "first_name": "DEAN",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "34006862S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64960313",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2085989",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.