NPIMap

Individual provider Active NPI

Mini Peterson Pathrose, M.D.

  • Family Medicine Physician
  • Hamilton, OH
National Provider Identifier
1538168844
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35080562P Issued in OH
Practice address
903 NW Washington Blvd
Suite B
Hamilton, OH 45013-6386
Phone
(513) 867-9000
Fax
(513) 785-3675
NPI assigned
Jul 19, 2005
Last updated
Nov 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35080562P OH Primary

Addresses

Primary practice location

903 NW Washington Blvd
Suite B
Hamilton, OH 45013-6386

Mailing address

903 NW Washington Blvd
Ste. B
Hamilton, OH 45013-6386
Phone (513) 867-9000

Other identifiers 1

IdentifierTypeStateIssuer
2357417MedicaidOH

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
I20040416000941 OH Practitioner - Family Practice 3274528500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trihealth G LLCGroup PAC ID 0749222651, 294 clinicians
Oxford Physical Therapy and RehabilitationGroup PAC ID 0244232874, 432 clinicians

Practice addresses (Care Compare)

2001 Anderson Ferry Rd
Cincinnati, OH 45238-3325
Phone (513) 246-7000

3145 Hamilton Mason Rd
Suite 300
Fairfield Township, OH 45011-8556
Phone (513) 863-6222

7567 Central Parke Blvd
A
Mason, OH 45040-6852

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35080562POHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth G, LLC CurrentSince Aug 1, 2016 Accepting new patients
Trihealth G LLC Family Medicine CurrentSince Aug 1, 2016 Accepting new patients
Trihealth G LLC Family Medicine Past Accepting new patients
Alliance Physician Inc Family Medicine Past Accepting new patients

Locations

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

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

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

3145 Hamilton Mason Rd
Fl 2
Fairfield Township, OH 45011
Phone (513) 867-0015

3145 Hamilton Mason Rd
Ste 300
Fairfield Township, OH 45011
Phone (513) 863-6222

Interoperability endpoints

  • Direct secure messaging: mpathrose38673@direct.trihealth.com

Organizations & group practices 5

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 12

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1538168844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 NW WASHINGTON BLVD",
            "address_2": "STE. B",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450136386",
            "telephone_number": "513-867-9000",
            "fax_number": "513-785-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 NW WASHINGTON BLVD",
            "address_2": "SUITE B",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450136386",
            "telephone_number": "513-867-9000",
            "fax_number": "513-785-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHROSE",
        "first_name": "MINI",
        "middle_name": "PETERSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35080562P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2357417",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

Verify at the official NPI Registry.