Active NPI
Jonathan James Gillman, PA-C
- Physician Assistant
- Dayton, OH
National Provider Identifier
1750474821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.002072
- Practice address
- 5491 Far Hills Ave
Dayton, OH 45429-2325 - Phone
- (937) 436-5763
- Fax
- (937) 436-7399
- NPI assigned
- Oct 2, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.002072 | OH | Primary |
Addresses
Primary practice location
5491 Far Hills Ave
Dayton, OH 45429-2325
Mailing address
6232 Karlsridge Dr
Centerville Finance, OH 45459-8402
Phone (937) 436-5763
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5491 Far Hills Ave
Dayton, OH 45429-2325
Phone (937) 436-5763
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.002072 | OH | MD | Physician Assistant |
Organizations & group practices 1
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.
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Dayton, OH
- NPI 1851423545
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Miamisburg, OH
- NPI 1316966518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750474821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6232 KARLSRIDGE DR",
"city": "CENTERVILLE FINANCE",
"state": "OH",
"postal_code": "454598402",
"telephone_number": "937-436-5763",
"fax_number": "937-436-7399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5491 FAR HILLS AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "454292325",
"telephone_number": "937-436-5763",
"fax_number": "937-436-7399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLMAN",
"first_name": "JONATHAN",
"middle_name": "JAMES",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.002072",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.