Individual provider Active NPI

Pavani Dantala, MD

  • Internal Medicine Physician
  • Middletown, OH
National Provider Identifier
1902009152
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.095144 Issued in OH
Practice address
1 Medical Center Dr
Middletown, OH 45005-2584
Phone
(513) 705-4754
Fax
(513) 420-5156
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 35095144 OH
Internal Medicine Physician 207R00000X 35.095144 OH Primary

Addresses

Primary practice location

1 Medical Center Dr
Middletown, OH 45005-2584

Mailing address

1 Medical Center Dr
Middletown, OH 45005-2584
Phone (513) 705-4754

Other identifiers 1

IdentifierTypeStateIssuer
3077674MedicaidOH

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
I20100929000862 OH Practitioner - Internal Medicine 7315063179 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mvhe Inc 399 clinicians
Hisey Physician Services, LLC 43 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Middletown, OH 45005-2584
Phone (513) 705-4754

3130 N Country Rd
25A
Troy, OH 45373-1337
Phone (937) 440-4000

Hospital & facility affiliations

  • Atrium Medical Center Hospital, Franklin, OH, CCN 360076

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.095144OHMDInternal Medicine Physician
35095144OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc Internal Medicine CurrentSince Oct 7, 2013 Accepting new patients
Hisey Physician Services, LLC Internal Medicine CurrentSince Mar 26, 2024 Accepting new patients
Sinclair Physician Services, LLC Internal Medicine CurrentSince May 1, 2024 Accepting new patients
Mvhe Inc Internal Medicine CurrentSince Oct 7, 2013 Accepting new patients
Mvhe Inc Internal Medicine Current Accepting new patients
Atrium Medical Center Past Accepting new patients
Hospitalist Medicine Physicians of Butler County, LTD Internal Medicine Past Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

Organizations & group practices 7

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 1

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1902009152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450052584",
            "telephone_number": "513-705-4754",
            "fax_number": "513-420-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450052584",
            "telephone_number": "513-705-4754",
            "fax_number": "513-420-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTALA",
        "first_name": "PAVANI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35095144",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.095144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3077674",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.