NPIMap

Organization Active NPI

Lincoln Park Surgery Center

  • Radiology Clinic/Center
  • Kettering, OH
National Provider Identifier
1912989526
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
1073-1C Issued in OH
Legal business name
LINCOLN PARK SURGERY CENTER
Practice address
500 Lincoln Park Blvd
Suite 100
Kettering, OH 45429-3492
Phone
(937) 424-5560
Fax
(937) 424-5876
NPI assigned
Nov 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Jonathan Paley, MD
Title
Partner
Phone
(937) 424-5560

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0730AS OH
Radiology Clinic/Center 261QR0200X 1073-1C OH Primary

Addresses

Primary practice location

500 Lincoln Park Blvd
Suite 100
Kettering, OH 45429-3492

Mailing address

500 Lincoln Park Blvd
Suite 100
Kettering, OH 45429-3492
Phone (937) 424-5560

Other identifiers 1

IdentifierTypeStateIssuer
2483638MedicaidOH

National Provider Directory

National Provider Directory

Locations

500 Lincoln Park Blvd
Ste 100
Kettering, OH 45429
Phone (937) 222-3118

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1912989526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD",
            "address_2": "SUITE 100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293492",
            "telephone_number": "937-424-5560",
            "fax_number": "937-424-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD",
            "address_2": "SUITE 100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293492",
            "telephone_number": "937-424-5560",
            "fax_number": "937-424-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN PARK SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PALEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "937-424-5560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OH",
            "license": "0730AS",
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "OH",
            "license": "1073-1C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2483638",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.