Active NPI
Brian J Ceccarelli, D. O.
- Orthopaedic Surgery Physician
- Dayton, OH
National Provider Identifier
1669474649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 3891
- Practice address
- 4160 Little York Rd
Ste. 10
Dayton, OH 45414-5800 - Phone
- (937) 415-9100
- Fax
- (937) 415-9191
- NPI assigned
- Aug 10, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 3891 | OH | Primary |
Addresses
Primary practice location
4160 Little York Rd
Ste. 10
Dayton, OH 45414-5800
Mailing address
PO Box 713130
Cincinnati, OH 45271-0001
Phone (937) 415-9100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0739008 | Medicaid | OH | |
| P00657291 | Other | OH | RR MEDICARE |
| 200021341 | Other | OH | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3891 | OH | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic Asoc of SW Ohio, Inc. | Orthopaedic Surgery | Past | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Orthopaedic Surgery Physician
- Dayton, OH
- NPI 1952303331
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317859200000",
"number": "1669474649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 713130",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452710001",
"telephone_number": "937-415-9100",
"fax_number": "937-415-9191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4160 LITTLE YORK RD",
"address_2": "STE. 10",
"city": "DAYTON",
"state": "OH",
"postal_code": "454145800",
"telephone_number": "937-415-9100",
"fax_number": "937-415-9191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CECCARELLI",
"first_name": "BRIAN",
"middle_name": "J",
"credential": "D. O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-10",
"last_updated": "2011-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "OH",
"license": "3891",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0739008",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00657291",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "200021341",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.