NPIMap

Individual provider Active NPI

Mickey E. Denen, MD

  • Pediatrics Physician
  • Dayton, OH
National Provider Identifier
1639118284
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.057283 Issued in OH
Practice address
6611 Clyo Rd
Suite a
Dayton, OH 45459-2786
Phone
(937) 208-7300
Fax
(937) 208-7330
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.057283 OH Primary

Addresses

Primary practice location

6611 Clyo Rd
Suite a
Dayton, OH 45459-2786

Mailing address

6611 Clyo Rd
Suite a
Dayton, OH 45459-2786
Phone (937) 208-7300

Other identifiers 1

IdentifierTypeStateIssuer
0823943MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
RESTful URL mdenen1189@direct.premierhealth.com

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
I20100204000391 OH Practitioner - Internal MedicinePractitioner - Pediatric Medicine 5991848582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Wright State University Boonshoft School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians

Practice addresses (Care Compare)

6611 Clyo Rd a
Centerville, OH 45459-2785
Phone (937) 208-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc CurrentSince Feb 11, 1993 Accepting new patients
Mvhe Inc CurrentSince Feb 11, 1993 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Mvhe Inc Pediatrics Past Accepting new patients
Miami Valley Hospital Past Accepting new patients
Mvhe Inc Past Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

6611 Clyo Rd
Ste A
Dayton, OH 45459
Phone (937) 208-7300

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

3140 E Dorothy Ln
Kettering, OH 45420
Phone (937) 208-7474

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1639118284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6611 CLYO RD",
            "address_2": "SUITE A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454592786",
            "telephone_number": "937-208-7300",
            "fax_number": "937-208-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6611 CLYO RD",
            "address_2": "SUITE A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454592786",
            "telephone_number": "937-208-7300",
            "fax_number": "937-208-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENEN",
        "first_name": "MICKEY",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.057283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0823943",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "mdenen1189@direct.premierhealth.com",
            "affiliation": "N",
            "address_1": "6611 Clyo Rd",
            "address_2": "Suite A",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454592786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.