Active NPI
Mauricio Daniel Carballo Montero, MD
- Gastroenterology Physician
- Dayton, OH
National Provider Identifier
1508173568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 35.138586
- Practice address
- 10863 Mariam LN
Dayton, OH 45458-6412 - Phone
- (937) 545-1539
- NPI assigned
- Sep 10, 2010
- Last updated
- Mar 5, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 35.138586 | OH | Primary |
Addresses
Primary practice location
10863 Mariam LN
Dayton, OH 45458-6412
Mailing address
10863 Mariam LN
Dayton, OH 45458-6412
Phone (937) 545-1539
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0396368 | Medicaid | OH |
Other names 1
- Mauricio Daniel Carballo
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
600 W Main St
Suite 330
Troy, OH 45373-3384
Phone (937) 458-0085
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.28 of 100
- Quality
- 99.21
- Improvement activities
- 40
- Cost
- 62.72
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 58 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 277 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Carmel Health System | Internal Medicine | Current | Accepting new patients |
| Kettering Independent Medical Group Inc | Internal Medicine | Current | Accepting new patients |
| Mount Carmel Health System | Current | Accepting new patients |
Locations
6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420
600 W Main St
Ste 330
Troy, OH 45373
Phone (937) 429-7350
477 Cooper Rd
Ste 300
Westerville, OH 43081
Phone (614) 898-8808
Interoperability endpoints
- mcarballo@crmg.gwaydirect.com
- mcarballomontero2369342@direct.trinity-health.org
Organizations & group practices 3
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.
-
- Orthopaedic Surgery Physician
- Miamisburg, OH
- NPI 1629387865
Internal Medicine
-
dba Mount Carmel Health System Physicians
- Internal Medicine Physician
- Columbus, OH
- NPI 1457617235
-
dba Mount Carmel Dublin
- General Acute Care Hospital
- Dublin, OH
- NPI 1710752183
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Kettering Health Dayton
- General Acute Care Hospital
- Dayton, OH
- NPI 1053339507
-
dba Kettering Health Troy
- General Acute Care Hospital
- Troy, OH
- NPI 1023587045
-
dba Kettering Health Main Campus
- General Acute Care Hospital
- Kettering, OH
- NPI 1043233984
-
- General Acute Care Hospital
- Dayton, OH
- NPI 1073688354
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772668800000",
"number": "1508173568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10863 MARIAM LN",
"city": "DAYTON",
"state": "OH",
"postal_code": "454586412",
"telephone_number": "937-545-1539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10863 MARIAM LN",
"city": "DAYTON",
"state": "OH",
"postal_code": "454586412",
"telephone_number": "937-545-1539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARBALLO MONTERO",
"first_name": "MAURICIO",
"middle_name": "DANIEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-10",
"last_updated": "2026-03-05",
"certification_date": "2026-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "OH",
"license": "35.138586",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0396368",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MAURICIO",
"last_name": "CARBALLO",
"middle_name": "DANIEL",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.