Active NPI
John M. Duchak III, MD
- Cardiovascular Disease Physician
- Dayton, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 35.064642
- Practice address
- 1126 S Main St
Dayton, OH 45409-2687 - Phone
- (937) 223-3053
- Fax
- (937) 463-1765
- NPI assigned
- Mar 17, 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 35.064642 | OH | Primary |
Addresses
Primary practice location
1126 S Main St
Dayton, OH 45409-2687
Mailing address
4000 Miamisburg Centerville Rd Ste 100
Miamisburg, OH 45342-7615
Phone (937) 866-0637
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110077875 | Other | OH | RAILROAD MEDICARE |
| 0952518 | Medicaid | OH |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | jduchak170515@direct.ketteringhealth.org |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- University of Toledo College of Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1141 N Monroe Dr
Xenia, OH 45385-1619
Phone (937) 490-2270
1380 E Stroop Rd
Kettering, OH 45429-4926
Phone (937) 293-3486
3535 Pentagon Blvd
Beavercreek, OH 45431-1705
3535 Pentagon Park Blvd
Suite 400
Dayton, OH 45431-1705
Phone (937) 490-2264
4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309
4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751
600 W Main St
Troy, OH 45373-3384
7677 Yankee St
Suite 140
Dayton, OH 45459-3475
Phone (866) 224-9472
Hospital & facility affiliations
- Kettering Health Miamisburg
- Kettering Health Dayton
- Kettering Health Main Campus
- Soin Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.34 of 100
- Quality
- 63.67
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.14
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.064642 | OH | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kettering Independent Medical Group Inc | Cardiovascular Disease | Current | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Professional Readers Group, Inc | Past | Accepting new patients |
Locations
68 Darst Rd
Dayton, OH 45440
Phone (937) 458-6700
812 Central Ave
Greenville, OH 45331
Phone (937) 548-1522
1380 E Stroop Rd
Kettering, OH 45429
Phone (937) 293-3486
4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910
4000 Miamisburg Centerville Rd
Ste 100
Miamisburg, OH 45342
Phone (937) 643-9939
70 Weller Dr
Tipp City, OH 45371
Phone (937) 298-4417
7677 Yankee St
Ste 140
Washington Township, OH 45459
Phone (866) 224-9472
Organizations & group practices 3
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.
-
- Orthopaedic Surgery Physician
- Miamisburg, OH
- NPI 1629387865
Cardiovascular Disease
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Specialist
- Cincinnati, OH
- NPI 1861445702
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Soin Medical Center
- General Acute Care Hospital
- Beavercreek, OH
- NPI 1760764849
-
dba Kettering Health Dayton
- General Acute Care Hospital
- Dayton, OH
- NPI 1053339507
-
dba Kettering Health Main Campus
- General Acute Care Hospital
- Kettering, OH
- NPI 1043233984
-
dba Kettering Health Miamisburg
- 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": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612137600000",
"number": "1841269057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 MIAMISBURG CENTERVILLE RD STE 100",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453427615",
"telephone_number": "937-866-0637",
"fax_number": "937-866-6713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1126 S MAIN ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092687",
"telephone_number": "937-223-3053",
"fax_number": "937-463-1765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUCHAK",
"first_name": "JOHN",
"middle_name": "M.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2021-02-01",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "OH",
"license": "35.064642",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110077875",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0952518",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "4000 Miamisburg Centerville Rd Ste 100",
"city": "Miamisburg",
"state": "OH",
"country_code": "US",
"postal_code": "453427615",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jduchak170515@direct.ketteringhealth.org",
"affiliation": "N",
"address_1": "4000 Miamisburg Centerville Rd Ste 100",
"city": "Miamisburg",
"state": "OH",
"country_code": "US",
"postal_code": "453427615",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Feb 1, 2021; 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.