Individual provider Active NPI

Michael J Pegram, CNP

  • Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1851725170
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.14769 Issued in OH
Practice address
222 Piedmont Ave
Cincinnati, OH 45219-4231
Phone
(513) 475-7505
Fax
(513) 475-7355
NPI assigned
Aug 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.14769 OH Primary

Addresses

Primary practice location

222 Piedmont Ave
Cincinnati, OH 45219-4231

Mailing address

222 Piedmont Ave
Cincinnati, OH 45219-4231
Phone (513) 475-7505

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
I20131104001577 OH Practitioner - Nurse Practitioner 3274768999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

222 Piedmont Ave
Cincinnati, OH 45219-4231
Phone (513) 475-7855

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
65.97
Promoting interoperability
100
Improvement activities
40
Cost
74.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.14769OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC Nurse Practitioner CurrentSince Aug 1, 2022 Accepting new patients
Qualified Emergency Specialists Inc Nurse Practitioner CurrentSince Jun 6, 2022 Accepting new patients

Locations

2830 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 245-3335

3590 Lucille Dr
Cincinnati, OH 45213
Phone (513) 475-7630

3120 Burnet Ave
Ste 406
Cincinnati, OH 45229
Phone (513) 558-7700

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

222 Piedmont Ave
Ste 2200
Cincinnati, OH 45219
Phone (513) 621-7777

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

3125 Hamilton Mason Rd
Fairfield Township, OH 45011
Phone (513) 394-8888

100 Arrow Springs Blvd
Lebanon, OH 45036
Phone (513) 282-7000

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

110 N Poplar St
Oxford, OH 45056
Phone (513) 523-2111

Interoperability endpoints

  • Direct secure messaging: mpegram51737@direct.uchealth.com

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 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": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1851725170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 PIEDMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452194231",
            "telephone_number": "513-475-7505",
            "fax_number": "513-475-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PIEDMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452194231",
            "telephone_number": "513-475-7505",
            "fax_number": "513-475-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGRAM",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-22",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.14769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.