Individual provider Active NPI

Pedro Ricardo Rademacher, M.D.

  • Nephrology Physician
  • Cincinnati, OH
National Provider Identifier
1609816461
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35-063313 Issued in OH
Practice address
4435 Aicholtz Rd
Ste 800 C
Cincinnati, OH 45245-1690
Phone
(513) 688-1500
Fax
(513) 753-2472
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35-063313 OH Primary
Nephrology Physician 207RN0300X 29055 KY

Addresses

Primary practice location

4435 Aicholtz Rd
Ste 800 C
Cincinnati, OH 45245-1690

Mailing address

4435 Aicholtz Rd
Ste 800 C
Cincinnati, OH 45245-1690
Phone (513) 688-1500

Other identifiers 3

IdentifierTypeStateIssuer
200070190MedicaidIN
64290554MedicaidKY
0703242MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-063313OHMDNephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1609816461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 AICHOLTZ RD",
            "address_2": "STE 800 C",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451690",
            "telephone_number": "513-688-1500",
            "fax_number": "513-753-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 AICHOLTZ RD",
            "address_2": "STE 800 C",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451690",
            "telephone_number": "513-688-1500",
            "fax_number": "513-753-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADEMACHER",
        "first_name": "PEDRO",
        "middle_name": "RICARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35-063313",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "KY",
            "license": "29055",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200070190",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64290554",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0703242",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.