NPIMap

Individual provider Active NPI

Mariano M Iberico, MD

  • Pulmonary Disease Physician
  • Miamisburg, OH
National Provider Identifier
1942227897
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
35-0558725 Issued in OH
Practice address
4000 Miamisburg Centerville Rd
Suite 450
Miamisburg, OH 45342-3908
Phone
(937) 439-3600
Fax
(937) 439-3786
NPI assigned
Jul 16, 2006
Last updated
Aug 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 35-058725 OH
Pulmonary Disease Physician 207RP1001X 35-0558725 OH Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 35-058725 OH

Addresses

Primary practice location

4000 Miamisburg Centerville Rd
Suite 450
Miamisburg, OH 45342-3908

Mailing address

PO Box 933242
Cleveland, OH 44193-0035
Phone (937) 439-3600

Other practice location 1

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8805

Other identifiers 1

IdentifierTypeStateIssuer
293507MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-0558725OHMDPulmonary Disease Physician
35-058725OHMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Associates of Lewistown Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Jose R. Acosta, M.D., P.C. Critical Care Medicine Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1942227897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933242",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930035",
            "telephone_number": "937-439-3600",
            "fax_number": "937-439-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MIAMISBURG CENTERVILLE RD",
            "address_2": "SUITE 450",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423908",
            "telephone_number": "937-439-3600",
            "fax_number": "937-439-3786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBERICO",
        "first_name": "MARIANO",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35-058725",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35-0558725",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "OH",
            "license": "35-058725",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293507",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.