Ulysses Tandoc, MD
Individual provider Active NPI Anesthesiology Physician · Morrow, OH
NPI 1902804453 · NPPES record last updated Jun 28, 2013
Key facts
- NPI
- 1902804453
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 35054398 (OH)
- Practice address
- 1241 Shawhan Rd
Morrow, OH 45152-9695 - Phone
- (513) 865-5204
- NPI assigned
- Jul 8, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120312000816 | OH | Practitioner - Anesthesiology | 2466611306 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35054398 | OH | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Group Practice, Inc | Anesthesiology | Current |
Accepting new patients |
| Southern Ohio Pathology Consultants Inc | Past | Accepting new patients | |
| Cincinnati Pain Management Consultants LTD | Past | Accepting new patients |
Locations
340 Thomas More Pkwy
Ste 220
Crestview Hills, KY 41017
Phone (859) 301-2211
375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432
538 Oak St
Cincinnati, OH 45219
Phone (513) 247-0224
10191 Evendale Commons Dr
Cincinnati, OH 45241
Phone (513) 817-1150
3125 Hamilton Mason Rd
Fairfield Township, OH 45011
Phone (513) 394-8888
10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206
10615 Montgomery Rd
Montgomery, OH 45242
Phone (513) 793-1999
10506 Montgomery Rd
Ste G103
Montgomery, OH 45242
Phone (513) 745-5120
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 35054398 | OH | Yes |
Addresses
Primary practice location
1241 Shawhan Rd
Morrow, OH 45152-9695
Mailing address
PO Box 632572
Cincinnati, OH 45263-2572
Phone (513) 865-5204
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0853385 | Medicaid | OH |
Other providers in Morrow, OH
- Brian Singstock
- Shelly Stahl
- Carol Stansel
- Siew Tin C Stewart
- Lisa Marie Streuer
- Gregory Alan Taylor
- Chestine Guevarra Toth
- Trust Healthcare Agency LLC
- Ruth Wagoner
- Kathern L Walker
All providers in Morrow, OH · Anesthesiology Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.