Individual provider Active NPI

Erik Poldemann, M.D.

  • Internal Medicine Physician
  • Dayton, OH
National Provider Identifier
1689069866
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.139384 Issued in OH
Practice address
1530 Needmore Rd Ste 300
Dayton, OH 45414-3980
Phone
(937) 276-4274
Fax
(937) 277-8476
NPI assigned
Apr 3, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 35.139384 OH Primary

Addresses

Primary practice location

1530 Needmore Rd Ste 300
Dayton, OH 45414-3980

Mailing address

3170 Kettering Blvd BLDG B
Moraine, OH 45439-1924
Phone (937) 991-3188

Other identifiers 1

IdentifierTypeStateIssuer
0413959MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address epoldemann564245@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: 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
I20200819001528 OH Practitioner - Interventional CardiologyPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 2466765839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

9000 N Main St
Suite 101
Englewood, OH 45415-1184
Phone (937) 223-4461

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc Internal Medicine CurrentSince Aug 31, 2022 Accepting new patients
Premier Health Specialists Inc CurrentSince Aug 31, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

1530 Needmore Rd
Ste 300
Dayton, OH 45414
Phone (937) 208-6745

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

2649 Salem Ave
Ste 510
Dayton, OH 45406
Phone (937) 277-4274

9000 N Main St
Ste 101
Englewood, OH 45415

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

3170 Kettering Blvd
Moraine, OH 45439
Phone (937) 208-6400

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

600 Aviator Ct
Ste 100
Vandalia, OH 45377
Phone (937) 208-7776

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1689069866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 KETTERING BLVD BLDG B",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391924",
            "telephone_number": "937-991-3188",
            "fax_number": "372-239-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 NEEDMORE RD STE 300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143980",
            "telephone_number": "937-276-4274",
            "fax_number": "937-277-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLDEMANN",
        "first_name": "ERIK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.139384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0413959",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "epoldemann564245@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "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": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.