Individual provider Active NPI

Michael Gilles

  • Gerontology Clinical Nurse Specialist
  • Dayton, OH
National Provider Identifier
1801209143
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X
License
APRN.CNS.15989 Issued in OH
Practice address
30 E Apple St Ste Nw3300
Dayton, OH 45409-2939
Phone
(937) 208-8394
Fax
(937) 208-8388
NPI assigned
Jun 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Management Registered Nurse 163WP0000X RN.352635 OH
Gerontology Clinical Nurse Specialist 364SG0600X APRN.CNS.15989 OH Primary

Addresses

Primary practice location

30 E Apple St Ste Nw3300
Dayton, OH 45409-2939

Mailing address

3170 Kettering Blvd BLDG B3
Moraine, OH 45439-1924
Phone (937) 991-3186

Other practice location 1

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-2723

Other practice location 2

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-2723

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190227000460 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 1557600103 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Wright State University Boonshoft School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

3130 N Country Rd
25A
Troy, OH 45373-1337
Phone (937) 440-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.352635OHMDPain Management Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc CurrentSince Dec 18, 2018 Accepting new patients
Premier Health Specialists Inc CurrentSince Jun 19, 2023 Accepting new patients
Premier Health Specialists Inc CurrentSince Jun 19, 2023 Accepting new patients
Premier Health Specialists Inc Current Accepting new patients
Mvhe Inc CurrentSince Dec 18, 2018 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

2350 Miami Valley Dr
Ste 210
Centerville, OH 45459
Phone (937) 276-8320

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

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

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

9000 N Main St
Ste G-35
Englewood, OH 45415
Phone (937) 276-8320

9000 N Main St
Ste 333
Englewood, OH 45415
Phone (937) 832-8400

501 Atrium Dr
Ste 201
Middletown, OH 45005
Phone (513) 974-8780

200 Medical Center Dr
Ste 300
Middletown, OH 45005
Phone (513) 423-1211

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

3170 Kettering Blvd
Bldg B3
Moraine, OH 45439
Phone (937) 991-3188

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

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

3130 N County Road 25A
Ste 107
Troy, OH 45373
Phone (937) 297-8253

Organizations & group practices 6

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": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1801209143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 KETTERING BLVD BLDG B3",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391924",
            "telephone_number": "937-991-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E APPLE ST STE NW3300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092939",
            "telephone_number": "937-208-8394",
            "fax_number": "937-208-8388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wyoming St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092722",
            "country_code": "US",
            "telephone_number": "937-208-2723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Wyoming St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092722",
            "country_code": "US",
            "telephone_number": "937-208-2723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLES",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pain Management",
            "state": "OH",
            "license": "RN.352635",
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "OH",
            "license": "APRN.CNS.15989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.