NPIMap

Individual provider Active NPI

Paul Russell Jennewine, MD

  • Internal Medicine Physician
  • Middletown, OH
National Provider Identifier
1790765725
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.072062 Issued in OH
Practice address
200 N Breiel Blvd
Middletown, OH 45042-3808
Phone
(513) 424-2535
Fax
(513) 424-0363
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.072062 OH Primary

Addresses

Primary practice location

200 N Breiel Blvd
Middletown, OH 45042-3808

Mailing address

200 N Breiel Blvd
Middletown, OH 45042-3808
Phone (513) 424-2535

Other identifiers 1

IdentifierTypeStateIssuer
2076962MedicaidOH

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
I20100720000507 OH Practitioner - Internal Medicine 4082796222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Toledo College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians

Practice addresses (Care Compare)

200 N Breiel Blvd
Middletown, OH 45042-3808
Phone (513) 424-2535

2451 Wayne Ave
Dayton, OH 45420-1893
Phone (937) 252-1831

Hospital & facility affiliations

  • Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
  • Kettering Homecare Home health agency, Kettering, OH, CCN 367778
  • Queen City Skilled Care LLC Home health agency, Cincinnati, OH, CCN 369173
  • Hospice Care of Middletown Inc Hospice, Middletown, OH, CCN 361626
  • Atrium Medical Center Hospital, Franklin, OH, CCN 360076
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Christ Hospital Hospital, Cincinnati, OH, CCN 360163
  • Bethesda North Hospital, Cincinnati, OH, CCN 360179
  • West Chester Hospital Hospital, West Chester, OH, CCN 360354

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc Internal Medicine CurrentSince Sep 8, 2014 Accepting new patients
Mvhe Inc Internal Medicine Current Accepting new patients
Mvhe Inc CurrentSince Sep 8, 2014 Accepting new patients
Mvhe Inc Internal Medicine Past Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

5971 Golf Club Ln
Fairfield Township, OH 45011
Phone (513) 785-4304

200 N Breiel Blvd
Middletown, OH 45042
Phone (513) 424-2535

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

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 9

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1790765725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423808",
            "telephone_number": "513-424-2535",
            "fax_number": "513-424-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423808",
            "telephone_number": "513-424-2535",
            "fax_number": "513-424-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNEWINE",
        "first_name": "PAUL",
        "middle_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.072062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2076962",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.