Individual provider Active NPI

Jay E Rissover, MD

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1639140890
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35053312R Issued in OH
Practice address
4620 Glendale Milford Rd
Suite 101
Cincinnati, OH 45242-3704
Phone
(513) 745-9993
Fax
(513) 745-9269
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35053312R OH Primary

Addresses

Primary practice location

4620 Glendale Milford Rd
Suite 101
Cincinnati, OH 45242-3704

Mailing address

PO Box 635156
Cincinnati, OH 45263-5156
Phone (513) 745-9993

Other identifiers 1

IdentifierTypeStateIssuer
0774505MedicaidOH

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
I20101111000690 OH Practitioner - Internal Medicine 2062422447 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35053312ROHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ash Internal Medicine, LLC Internal Medicine CurrentSince Jan 1, 1994 Accepting new patients
Trihealth G LLC Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Trihealth G, LLC CurrentSince Jan 1, 2016 Accepting new patients

Locations

4260 Glendale Milford Rd
Ste 101
Blue Ash, OH 45242
Phone (513) 745-9993

425 Farrell Ct
Cincinnati, OH 45233
Phone (513) 451-6871

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

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

4360 Cooper Rd
Ste 301
Cincinnati, OH 45242
Phone (513) 745-9993

5861 Cinema Dr
Milford, OH 45150
Phone (513) 248-8800

Interoperability endpoints

  • Direct secure messaging: jrissover33952@direct.trihealth.com

Organizations & group practices 3

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1639140890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635156",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635156",
            "telephone_number": "513-745-9993",
            "fax_number": "513-745-9269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 GLENDALE MILFORD RD",
            "address_2": "SUITE 101",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452423704",
            "telephone_number": "513-745-9993",
            "fax_number": "513-745-9269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISSOVER",
        "first_name": "JAY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35053312R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0774505",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.