NPIMap

Organization Active NPI

Emergency Medicine Specialists, Inc

  • Emergency Medicine Physician
  • Beavercreek, OH
National Provider Identifier
1750650776
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY MEDICINE SPECIALISTS, INC
Practice address
3535 Pentagon Boulevard
Beavercreek, OH 45431
Phone
(937) 436-4658
NPI assigned
Dec 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Authorized official

Name
William Brady, MD
Title
President
Phone
(937) 438-8910

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

3535 Pentagon Boulevard
Beavercreek, OH 45431

Mailing address

3131 Newmark Dr Ste 220
Miamisburg, OH 45342-5400
Phone (937) 436-4658

Other identifiers 1

IdentifierTypeStateIssuer
0061443MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031114000252 OH Part B Supplier - Clinic/Group Practice 7315851359 Receives reassigned benefits from 187 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kettering, OH; Xenia, OH; Troy, OH; Springfield, OH; Middletown, OH; Miamisburg, OH; Huber Heights, OH; Franklin, OH…

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 84

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 84

NPI Registry JSON

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1750650776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 NEWMARK DR STE 220",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453425400",
            "telephone_number": "937-436-4658",
            "fax_number": "937-436-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 PENTAGON BOULEVARD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "45431",
            "telephone_number": "937-436-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY MEDICINE SPECIALISTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-438-8910",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0061443",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.