Individual provider Active NPI

Jeremy Michael Sikora, M.D.

  • General Practice Physician
  • Dayton, OH
National Provider Identifier
1679667828
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
35.088029 Issued in OH
Practice address
4881 Sugar Maple Dr
88 Mdos/Sgoma
Dayton, OH 45433-5529
Phone
(937) 257-1684
Fax
(937) 257-1634
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 35.088029 OH Primary

Addresses

Primary practice location

4881 Sugar Maple Dr
88 Mdos/Sgoma
Dayton, OH 45433-5529

Mailing address

4881 Sugar Maple Dr
88 Mdos/Sgoma
Dayton, OH 45433-5529
Phone (937) 257-1684

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
I20141015001751 OH Practitioner - Allergy/Immunology 2365663440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Northeastern Ohio University College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PSF PLLCGroup PAC ID 1557265543, 98 clinicians

Practice addresses (Care Compare)

2359 Lakeview Dr
Beavercreek, OH 45431-3695
Phone (800) 999-1249

Merit-based Incentive Payment System (MIPS)

Final score
84.25 of 100Reported as group
Quality
86.03
Promoting interoperability
86
Improvement activities
40
Cost
73.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.088029OHMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PSF PLLC CurrentSince Dec 6, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2359 Lakeview Dr
Beavercreek, OH 45431
Phone (937) 431-0721

6275 E Broad St
Ste 100
Columbus, OH 43213
Phone (614) 759-4730

6252 Wilmington Pike
Ste B
Dayton, OH 45459
Phone (937) 234-4919

7927 Jessies Way
Hamilton, OH 45011
Phone (513) 894-0500

8501 Troy Pike
Ste 110
Huber Heights, OH 45424
Phone (937) 237-5101

2194 Kings Mills Rd
Mason, OH 45040
Phone (513) 229-9090

209 Rivers Edge
Milford, OH 45150
Phone (513) 274-2230

2121 E High St
Ste C
Springfield, OH 45505
Phone (937) 323-3585

Interoperability endpoints

  • Direct secure messaging: jeremy.m.sikora.familyallergyasthma@faa.meditab.direct-ci.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1679667828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "address_2": "88 MDOS/SGOMA",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-257-1684",
            "fax_number": "937-257-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "address_2": "88 MDOS/SGOMA",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-257-1684",
            "fax_number": "937-257-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIKORA",
        "first_name": "JEREMY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35.088029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.