NPIMap

Individual provider Active NPI

Jon Berkeley Silk Jr., MD

  • Family Medicine Physician
  • Piqua, OH
National Provider Identifier
1720277486
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.098705 Issued in OH
Practice address
1752 W High St
Piqua, OH 45356-9325
Phone
(937) 773-3737
NPI assigned
Oct 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.098705 OH Primary

Addresses

Primary practice location

1752 W High St
Piqua, OH 45356-9325

Mailing address

3170 Kettering Blvd BLDG B2
Moraine, OH 45439-1924
Phone (937) 991-3188

Other identifiers 1

IdentifierTypeStateIssuer
0065396MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
RESTful URL jsilk11990@direct.premierhealth.com

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
I20120713000382 OH Practitioner - Family Practice 3870758048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Upper Valley Professional CorporationGroup PAC ID 5597658138, 83 clinicians

Practice addresses (Care Compare)

1752 W High St
Piqua, OH 45356-9325
Phone (937) 773-3737

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.89 of 100Reported as group
Quality
83.16
Promoting interoperability
100
Improvement activities
40
Cost
79.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.098705OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Family Care Inc CurrentSince Mar 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1530 Needmore Rd
Ste 200
Dayton, OH 45414
Phone (937) 278-5854

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

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 3

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": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1720277486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 KETTERING BLVD BLDG B2",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391924",
            "telephone_number": "937-991-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 W HIGH ST",
            "city": "PIQUA",
            "state": "OH",
            "postal_code": "453569325",
            "telephone_number": "937-773-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILK",
        "first_name": "JON",
        "middle_name": "BERKELEY",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-18",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.098705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065396",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "jsilk11990@direct.premierhealth.com",
            "affiliation": "N",
            "address_1": "1752 W High St",
            "city": "Piqua",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453569325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Piqua, OH

Sources for this page

Verify at the official NPI Registry.