Organization Active NPI

My Doctor, LLC

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1871574707
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MY DOCTOR, LLC
Practice address
9050 Montgomery Rd
Suite B
Cincinnati, OH 45242-7712
Phone
(513) 631-6963
Fax
(513) 631-1970
NPI assigned
Nov 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Authorized official

Name
Dr. Douglas A Magenheim, M.DNPI 1871574780
Title
President
Phone
(513) 631-6963

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

9050 Montgomery Rd
Suite B
Cincinnati, OH 45242-7712

Mailing address

9050 Montgomery Rd
Suite B
Cincinnati, OH 45242-7712
Phone (513) 631-6963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040910000784 OH Part B Supplier - Clinic/Group Practice 0749257707 Receives reassigned benefits from 4 practitioners
Practice locations: Cincinnati, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1009155My Doctor LLC9050 Montgomery Road Suite B, Cincinnati, OH 45242Certificate of waiverFeb 6, 2027

National Provider Directory

National Provider Directory

Locations

9050 Montgomery Rd
Cincinnati, OH 45242
Phone (513) 631-6963

9050 Montgomery Rd
Ste B
Cincinnati, OH 45242
Phone (513) 631-6963

9549 Montgomery Rd
Ste 110
Montgomery, OH 45242
Phone (513) 631-6963

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1871574707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 MONTGOMERY RD",
            "address_2": "SUITE B",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452427712",
            "telephone_number": "513-631-6963",
            "fax_number": "513-631-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 MONTGOMERY RD",
            "address_2": "SUITE B",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452427712",
            "telephone_number": "513-631-6963",
            "fax_number": "513-631-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY DOCTOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "MAGENHEIM",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-631-6963",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.