Individual provider Active NPI

Jerome Brian Huebsch, D.O.

  • Anesthesiology Physician
  • Kettering, OH
National Provider Identifier
1851669717
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
34.010888 Issued in OH
Practice address
1106 Gardner Rd
Kettering, OH 45429-4524
Phone
(937) 867-2235
NPI assigned
Dec 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 58.004204 OH
Anesthesiology Physician 207L00000X 34.010888 OH Primary

Addresses

Primary practice location

1106 Gardner Rd
Kettering, OH 45429-4524

Mailing address

1106 Gardner Road
Kettering, OH 45429
Phone (937) 867-2235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150716000220 WI Practitioner - Anesthesiology 7911146584 Reassigns benefits to 1 organization
I20200513000808 OH Practitioner - Hospitalist 7911146584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Anesthesia and Pain Services LLCGroup PAC ID 8022245372, 217 clinicians

Practice addresses (Care Compare)

405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 226-3200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58.004204OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Anesthesia & Pain Services, LLC Anesthesiology CurrentSince Mar 1, 2020 Accepting new patients
Brookfield Anesthesiologists, S.C. Anesthesiology CurrentSince Jan 1, 2019 Accepting new patients
Chad Novasic PT LTD PastSince Jan 1, 2019 Accepting new patients

Locations

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

7401 104th Ave
#100
Kenosha, WI 53142
Phone (262) 697-1006

7401 104th Ave
Kenosha, WI 53142
Phone (262) 697-1006

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.

Hospital & facility affiliations 4

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": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1851669717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 GARDNER ROAD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "45429",
            "telephone_number": "937-867-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 GARDNER RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454294524",
            "telephone_number": "937-867-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUEBSCH",
        "first_name": "JEROME",
        "middle_name": "BRIAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-07",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "58.004204",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "34.010888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.