NPIMap

Individual provider Active NPI

Keith M Wilson, M.D.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Cincinnati, OH
National Provider Identifier
1528009768
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
35062146 Issued in OH
Practice address
222 Piedmont Ave
Cincinnati, OH 45219-4231
Phone
(513) 475-8400
Fax
(513) 475-8228
NPI assigned
Jun 9, 2006
Last updated
Dec 12, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 35062146 OH Primary

Addresses

Primary practice location

222 Piedmont Ave
Cincinnati, OH 45219-4231

Mailing address

PO Box 636256 Central Credentialing
Cincinnati, OH 45263-6256
Phone (513) 585-5507

Other identifiers 1

IdentifierTypeStateIssuer
1528009768OtherOHRAILROAD MEDICARE

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
I20100526000140 OH Practitioner - Otolaryngology 8628107869 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
JS Weill Medical College, Cornell University, 1986
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)

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

10506 A Montgomery Rd
Montgomery, OH 45242-4402

375 Dixmyth Ave
Cincinnati, OH 45220-2475

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

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
Upper gastrointestinal (GI) endoscopy for acid reflux12
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35062146OHMDPlastic Surgery within the Head & Neck (Otolaryngology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth G, LLC CurrentSince Oct 15, 2018 Accepting new patients
Trihealth G LLC CurrentSince Oct 15, 2018 Accepting new patients
Trihealth H LLC CurrentSince Nov 1, 2021 Accepting new patients
University Ear, Nose and Throat Specialists, Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Daniel Drake Center for Post-Acute Care, LLC Past Accepting new patients
Trihealth Physician Institute Past Accepting new patients

Locations

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

379 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-1400

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

70 Damon Rd
Cincinnati, OH 45218
Phone (513) 605-1000

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

Interoperability endpoints

  • Direct secure messaging: kwilson37502@direct.trihealth.com

Organizations & group practices 7

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 6

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1528009768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256 CENTRAL CREDENTIALING",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-585-5507",
            "fax_number": "513-585-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PIEDMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452194231",
            "telephone_number": "513-475-8400",
            "fax_number": "513-475-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KEITH",
        "middle_name": "M",
        "name_prefix": "Prof.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "OH",
            "license": "35062146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "1528009768",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.