Individual provider Active NPI

Sara Lynn Kocian, DO

  • Emergency Medicine Physician
  • Kettering, OH
National Provider Identifier
1902394828
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34.014980 Issued in OH
Practice address
3525 Southern Blvd
Kettering, OH 45429-1221
NPI assigned
Apr 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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
Emergency Medicine Physician 207P00000X 34.014980 OH Primary

Addresses

Primary practice location

3525 Southern Blvd
Kettering, OH 45429-1221

Mailing address

3525 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8839

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
I20210930002662 OH Practitioner - Emergency Medicine 0749544930 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.014980OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Miami Valley Emergency Specialists, LLC Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
PHS Emergency Billing LLC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients

Locations

2400 Lakeview Dr
#150
Beavercreek, OH 45431

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

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1902394828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-8839",
            "fax_number": "937-395-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCIAN",
        "first_name": "SARA",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.014980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.