Individual provider Active NPI

John Michael Ballester, M.D.

  • Emergency Medicine Physician
  • Dayton, OH
National Provider Identifier
1710190087
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35079397 Issued in OH
Practice address
1 Wyoming St
Dayton, OH 45409-2722
Phone
(937) 208-3356
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35079397 OH Primary

Addresses

Primary practice location

1 Wyoming St
Dayton, OH 45409-2722

Mailing address

6572 Farmbrook CT
Mason, OH 45040-8962
Phone (513) 459-1003

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
I20050505000321 OH Practitioner - Emergency Medicine 2062452493 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35079397OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PHS Emergency Billing LLC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Miami Valley Emergency Specialists, LLC Emergency Medicine CurrentSince Jan 21, 2005 Accepting new patients
Vanguard Medical Emergency Medicine Past Accepting new patients

Locations

2400 Lakeview Dr
#150
Beavercreek, OH 45431

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394

4940 Cottonville Rd
Jamestown, OH 45335
Phone (937) 298-4417

300 Austin West Blvd
Miamisburg, OH 45342
Phone (937) 388-7911

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1710190087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6572 FARMBROOK CT",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408962",
            "telephone_number": "513-459-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLESTER",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35079397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.