Individual provider Active NPI

Adan A Fuentes, D.O.

  • Otolaryngology Physician
  • Dayton, OH
National Provider Identifier
1477573327
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
34008361 Issued in OH
Practice address
1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684
Phone
(937) 496-2600
Fax
(937) 496-2610
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 34008361 OH Primary

Addresses

Primary practice location

1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684

Mailing address

1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684
Phone (937) 496-2600

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041116000889 OH Practitioner - Otolaryngology 0547224818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Ohio University, College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Ohio ENT Specialists IncGroup PAC ID 2163403098, 42 clinicians

Practice addresses (Care Compare)

1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2642
Phone 9374962620437

Hospital & facility affiliations

  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34008361OHMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Ohio ENT Specialists Inc Otolaryngology CurrentSince Jul 1, 2008 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

6601 Centerville Business Pkwy
Dayton, OH 45459
Phone (937) 208-2111

1222 S Patterson Blvd
Ste 400
Dayton, OH 45402
Phone (937) 496-2600

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

1 Childrens Plz
Lowr
Dayton, OH 45404

6601 Centerville Business Pkwy
Ste 200
Dayton, OH 45459
Phone (937) 435-7476

9000 N Main St
Ste 320
Englewood, OH 45415
Phone (937) 496-2600

5971 Golf Club Ln
Fairfield Township, OH 45011
Phone (513) 785-4304

1930 Prime Ct
Ste 104
Troy, OH 45373
Phone (937) 832-3582

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDIFCD
  • Direct secure messaging: adan.fuentes@swoes.eclinicaldirectplus.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 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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1477573327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "address_2": "SUITE 400",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-496-2600",
            "fax_number": "937-496-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "address_2": "SUITE 400",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-496-2600",
            "fax_number": "937-496-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "ADAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "34008361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.