Edward A Hubach, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34002371H Issued in OH

Practice address

6255 Chambersburg Road
Huber Heights, OH 45424

Phone

(937) 233-7141

Fax

(937) 233-1956

NPI assigned

May 30, 2005

Last updated

Aug 29, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Medical Group

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1972533149
  Medicare reassignment NPD
• Providence Health Partners

  dba Center for Clinical Research

  • Research Clinic/Center
  • Moraine, OH
  • NPI 1912261744
  Authorized official Same address or phone
• Providence Medical Group, Inc.

  dba PMG Vascular Imaging

  • Diagnostic Radiology Physician
  • Moraine, OH
  • NPI 1659726768
  NPD

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

{
    "created_epoch": "1117411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1821091331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2912 SPRINGBORO W",
            "address_2": "STE 201",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454391674",
            "telephone_number": "937-297-8999",
            "fax_number": "937-297-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 CHAMBERSBURG ROAD",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "45424",
            "telephone_number": "937-233-7141",
            "fax_number": "937-233-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBACH",
        "first_name": "EDWARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-30",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34002371H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0120089",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "421534506094",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000227899",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080191719",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA/CHOICECARE",
            "identifier": "D0237103",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0279087",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR WC",
            "identifier": "220226705",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "34002371",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "635756",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deidra Hopkins
• Horn Solutions LLC
• Craig A. Horn, MD
• Sherry Ann Howard
• Natalie Hoza, DMD
• Huber Heights City School District
• Huber Heights Health Services Inc (Huber Heights Urgent Care)
• Huber Heights Holdings, LLC (AM Behavioral Huber Heights)
• Huber Heights Holdings, LLC (AM Behavioral Huber Heights)
• Huber Heights Holdings, LLC (AM Behavioral Huber Heights)

• Family Medicine Physician in Huber Heights, OH
• Providers in Huber Heights, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.