NPIMap

Individual provider Active NPI

Nicholas Anthony Eberly

  • Otolaryngology Physician
  • Fairfield, OH
National Provider Identifier
1861887515
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
34.013086 Issued in OH
Practice address
2960 Mack Rd Ste 205
Fairfield, OH 45014-5300
Phone
(513) 825-5454
Fax
(513) 825-5452
NPI assigned
Mar 31, 2015
Last updated
Feb 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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 NU
Otolaryngology Physician 207Y00000X 34.013086 OH Primary

Addresses

Primary practice location

2960 Mack Rd Ste 205
Fairfield, OH 45014-5300

Mailing address

2960 Mack Rd Ste 205
Fairfield, OH 45014-5300
Phone (513) 825-5454

Other practice location 1

5100 W Broad St
Columbus, OH 43228-1607
Phone (614) 544-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200827002352 OH Practitioner - Otolaryngology 6204102833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5075 Pkwy Dr
Suite 101
Mason, OH 45040-9555
Phone (513) 686-5392

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.013086OHMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians Cincinnati, LLC CurrentSince Sep 1, 2020 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians Cincinnati LLC CurrentSince Sep 1, 2020 Accepting new patients

Locations

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

2960 Mack Rd
Ste 205
Fairfield, OH 45014
Phone (513) 825-5454

5075 Parkway Dr
Ste 101
Mason, OH 45040
Phone (513) 584-6898

201 Old Bank Rd
Ste 103
Milford, OH 45150
Phone (513) 248-0100

Interoperability endpoints

  • Direct secure messaging: neberly734006@direct.bsmhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1861887515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 MACK RD STE 205",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145300",
            "telephone_number": "513-825-5454",
            "fax_number": "513-825-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 MACK RD STE 205",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145300",
            "telephone_number": "513-825-5454",
            "fax_number": "513-825-5452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5100 W Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432281607",
            "country_code": "US",
            "telephone_number": "614-544-1000",
            "fax_number": "614-544-1751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBERLY",
        "first_name": "NICHOLAS",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "34.013086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.