Individual provider Active NPI

Jay Michael Tennie, MD

  • Emergency Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1568467033
Registry record updated Apr 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
350704410 Issued in OH
Practice address
3131 Queen City Ave
Cincinnati, OH 45238-2316
Phone
(513) 557-3333
Fax
(513) 557-3332
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 350704410 OH Primary

Addresses

Primary practice location

3131 Queen City Ave
Cincinnati, OH 45238-2316

Mailing address

1472 Solutions Ctr
Chicago, IL 60677-1004
Phone (513) 557-3333

Other identifiers 3

IdentifierTypeStateIssuer
2070155MedicaidOH
64085830MedicaidKY
200219260MedicaidIN

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
I20040824001499 OH Practitioner - Emergency Medicine 1153395116 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
350704410OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Qualified Emergency Specialists Inc Emergency Medicine CurrentSince Jul 1, 1998 Accepting new patients

Locations

1472 Solutions Ctr
Chicago, IL 60677

3000 Hospital Dr
Batavia, OH 45103
Phone (513) 557-3209

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

6949 Good Samaritan Dr
Cincinnati, OH 45247
Phone (513) 246-9800

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

3131 Queen City Ave
Cincinnati, OH 45238
Phone (513) 557-3209

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

10400 New Haven Rd
Harrison, OH 45030
Phone (513) 367-5888

100 Arrow Springs Blvd
Lebanon, OH 45036
Phone (513) 282-7000

1618 Deerfield Rd
Lebanon, OH 45036
Phone (513) 557-3209

10506 Montgomery Rd
Ste 209
Montgomery, OH 45242
Phone (513) 794-1601

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

110 N Poplar St
Oxford, OH 45056
Phone (513) 523-2111

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209254400000",
    "number": "1568467033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1472 SOLUTIONS CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771004",
            "telephone_number": "513-557-3333",
            "fax_number": "513-557-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 QUEEN CITY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452382316",
            "telephone_number": "513-557-3333",
            "fax_number": "513-557-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNIE",
        "first_name": "JAY",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2008-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "350704410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2070155",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64085830",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200219260",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.