NPIMap

Individual provider Active NPI

Katherine Suzanne De la Pena

  • Internal Medicine Physician
  • Kettering, OH
National Provider Identifier
1659802973
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34.014407 Issued in OH
Practice address
1745 E Stroop Rd
Kettering, OH 45429-5039
Phone
(937) 281-6340
Fax
(937) 281-6342
NPI assigned
Mar 27, 2017
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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 34.014407 OH Primary

Addresses

Primary practice location

1745 E Stroop Rd
Kettering, OH 45429-5039

Mailing address

1745 E Stroop Rd
Kettering, OH 45429-5039
Phone (937) 281-6340

Other practice location 1

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7351

Other identifiers 1

IdentifierTypeStateIssuer
0231602MedicaidOH

Other names 1

  • Katherine Suzanne McCarthy Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kdelapena575026@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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
I20200714000372 OH Practitioner - Internal Medicine 0547532855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

101 E Alex Bell Rd
Suite 190
Dayton, OH 45459-2752
Phone (937) 425-4030

1625 S Alex Rd
West Carrollton, OH 45449-5404
Phone (937) 865-0534

1745 E Stroop Rd
Kettering, OH 45429-5039
Phone (937) 381-6340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
73.21
Promoting interoperability
100
Improvement activities
40
Cost
76.12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Alliance Physicians, Inc. Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Kettering Network Radiologists Inc PastSince Aug 25, 2024 Accepting new patients

Locations

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

1425 E Stroop Rd
Kettering, OH 45429
Phone (937) 298-6654

1745 E Stroop Rd
Kettering, OH 45429
Phone (937) 281-6340

4441 Far Hills Ave
Kettering, OH 45429
Phone (937) 298-7351

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1659802973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 E STROOP RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295039",
            "telephone_number": "937-281-6340",
            "fax_number": "937-281-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 E STROOP RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295039",
            "telephone_number": "937-281-6340",
            "fax_number": "937-281-6342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4441 Far Hills Ave",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454292405",
            "country_code": "US",
            "telephone_number": "937-298-7351",
            "fax_number": "937-298-9458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA PENA",
        "first_name": "KATHERINE",
        "middle_name": "SUZANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.014407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0231602",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdelapena575026@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "4441 Far Hills Ave",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454292405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4441 Far Hills Ave",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454292405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "MCCARTHY",
            "middle_name": "SUZANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.