Individual provider Active NPI

Jeff Bare, DO

  • Emergency Medicine Physician
  • Newark, OH
National Provider Identifier
1629076898
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34006997 Issued in OH
Practice address
1320 W Main St
Newark, OH 43055-1822
Phone
(220) 564-4151
Fax
(220) 564-7153
NPI assigned
Jul 12, 2005
Last updated
Mar 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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 34006997 OH Primary

Addresses

Primary practice location

1320 W Main St
Newark, OH 43055-1822

Mailing address

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-4151

Other practice location 1

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-7153

Other practice location 2

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-7153

Other identifiers 1

IdentifierTypeStateIssuer
2188609MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jbare14305@lickingmemorial.medicity.net Other LICKING MEMORIAL PROFESSIONAL CORPORATION
Direct Messaging Address jbare14305@lickingmemorial.medicity.net Other LICKING MEMORIAL PROFESSIONAL CORPORATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091118000672 OH Practitioner - Emergency Medicine 2264570894 Reassigns benefits to 1 organization
I20170208000029 TX Practitioner - Emergency Medicine 2264570894 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Round Table Physicians Group PLLCGroup PAC ID 0547682460, 80 clinicians

Practice addresses (Care Compare)

120 McMillen Dr
Newark, OH 43055-1809
Phone (220) 564-4806

1320 W Main St
Newark, OH 43055-1822

36 McMillen Dr
Newark, OH 43055-1809
Phone (220) 564-4270

88 McMillen Dr
Newark, OH 43055-1809
Phone (220) 564-4270

8910 Hwy 6 S
Houston, TX 77083-6339
Phone (832) 699-3777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
75.66
Promoting interoperability
100
Improvement activities
40
Cost
75.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34006997OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Round Table Physicians Group PLLC CurrentSince Mar 1, 2020 Accepting new patients
Licking Memorial Health Professionals Current Accepting new patients
Licking Memorial Professional Corporation CurrentSince Oct 11, 2009 Accepting new patients
Licking Memorial Professional Corporation CurrentSince Oct 11, 2009 Accepting new patients
Round Table Specialist Group, PLLC Emergency Medicine Current Accepting new patients
Acute Care Specialists Emergency Medicine CurrentSince Dec 11, 2016 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients

Locations

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

1320 W Main St
Ste Er
Newark, OH 43055
Phone (740) 348-4598

5701 W Slaughter Ln
Bldg G
Austin, TX 78749
Phone (512) 651-5787

1512 Texas Ave S
Ste 500
College Station, TX 77840
Phone (979) 213-5728

1007 Westheimer Rd
Houston, TX 77006
Phone (281) 479-3293

1014 Wirt Rd
Ste 200
Houston, TX 77055
Phone (713) 527-5000

11103 Westheimer Rd
Houston, TX 77042
Phone (832) 708-3651

5003 FM 1960 Rd W
Houston, TX 77069
Phone (281) 213-5444

5413 S Rice Ave
Houston, TX 77081
Phone (713) 527-5000

5835 Highway 6 N
Houston, TX 77084
Phone (281) 861-0937

8910 Highway 6 S
Houston, TX 77083
Phone (281) 258-4351

800 W Central Texas Expy
Killeen, TX 76541
Phone (254) 220-4117

1596 W Main St
Lewisville, TX 75067
Phone (469) 312-3660

323 E Hawkins Pkwy
Longview, TX 75605
Phone (903) 315-2000

5409 W Wadley Ave
Midland, TX 79707
Phone (432) 699-2601

2731 N Grandview Ave
Odessa, TX 79762
Phone (432) 366-0945

3055 NE Loop 286
Paris, TX 75460
Phone (903) 737-1111

3531 S Main St
Stafford, TX 77477
Phone (281) 410-2009

2001 Mall Dr
Texarkana, TX 75503
Phone (903) 306-2126

Organizations & group practices 8

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 1

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1629076898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551822",
            "telephone_number": "220-564-4151",
            "fax_number": "220-564-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551822",
            "telephone_number": "220-564-4151",
            "fax_number": "220-564-7153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 W Main St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430551822",
            "country_code": "US",
            "telephone_number": "220-564-7153",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1320 W Main St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430551822",
            "country_code": "US",
            "telephone_number": "220-564-7153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARE",
        "first_name": "JEFF",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34006997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2188609",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbare14305@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "endpointDescription": "DIRECT EMAIL ADDRESS",
            "affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbare14305@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "endpointDescription": "DIRECT EMAIL ADDRESS",
            "affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.