Individual provider Active NPI

Riyad J Tayim, MD

  • Surgery Physician
  • Kettering, OH
National Provider Identifier
1841600574
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35.130996 Issued in OH
Practice address
3533 Southern Blvd
Ste 2250
Kettering, OH 45429-1270
Phone
(937) 534-0330
Fax
(937) 522-8995
NPI assigned
May 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35.130996 OH Primary

Addresses

Primary practice location

3533 Southern Blvd
Ste 2250
Kettering, OH 45429-1270

Mailing address

3533 Southern Blvd Ste 2250
Kettering, OH 45429-1270
Phone (937) 534-0330

Other identifiers 1

IdentifierTypeStateIssuer
0371274MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rtayim516814@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191030002224 OH Practitioner - General Surgery 8022230333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wright State University Boonshoft School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3533 Southern Blvd
Suite 2200
Kettering, OH 45429-1264
Phone (937) 228-4126

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

Hospital & facility affiliations

  • Kettering Homecare Home health agency, Kettering, OH, CCN 367778
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.130996OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc Surgery CurrentSince Dec 29, 2022 Accepting new patients
Kettering Medical Center Past Accepting new patients

Locations

1380 NW Washington Blvd
Hamilton, OH 45013
Phone (513) 863-2800

3533 Southern Blvd
Ste 2250
Kettering, OH 45429
Phone (937) 534-0330

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

3700 Southern Blvd
Ste 401
Kettering, OH 45429
Phone (855) 500-2873

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

Organizations & group practices 2

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 5

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": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1841600574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD STE 2250",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291270",
            "telephone_number": "937-534-0330",
            "fax_number": "937-522-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD",
            "address_2": "STE 2250",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291270",
            "telephone_number": "937-534-0330",
            "fax_number": "937-522-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYIM",
        "first_name": "RIYAD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.130996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0371274",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rtayim516814@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3533 SOUTHERN BLVD",
            "address_2": "STE 2250",
            "city": "KETTERING",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3533 SOUTHERN BLVD",
            "address_2": "STE 2250",
            "city": "KETTERING",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.