Active NPI
Samuel J Delaune, MD
- Emergency Medicine Physician
- Cincinnati, OH
National Provider Identifier
1649489733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 47820
- Practice address
- 3333 Burnet Ave
ML 5018
Cincinnati, OH 45229 - Phone
- (513) 636-4315
- Fax
- (513) 636-7905
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 57011984 | OH | |
| Emergency Medicine Physician | 207P00000X | 47820 | TN | Primary |
Addresses
Primary practice location
3333 Burnet Ave
ML 5018
Cincinnati, OH 45229
Mailing address
3333 Burnet Ave
ML 5018
Cincinnati, OH 45229
Phone (513) 636-4315
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- University of Texas Medical Branch at Galveston, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.33 of 100
- Quality
- 83.8
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47820 | TN | MD | Emergency Medicine Physician |
| 57011984 | OH | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-Cities Regional Emergency Physicians, PC | Emergency Medicine | Current | Accepting new patients |
Locations
1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300
400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310
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.
-
- Emergency Medicine Physician
- Johnson City, TN
- NPI 1063950046
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412208000000",
"number": "1649489733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 BURNET AVE",
"address_2": "ML 5018",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45229",
"telephone_number": "513-636-4315",
"fax_number": "513-636-7905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 BURNET AVE",
"address_2": "ML 5018",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45229",
"telephone_number": "513-636-4315",
"fax_number": "513-636-7905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELAUNE",
"first_name": "SAMUEL",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2014-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OH",
"license": "57011984",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TN",
"license": "47820",
"primary": true
}
],
"identifiers": [],
"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 Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.