Mary Ellen Broadstone Gaeke, MD, LLC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

MARY ELLEN BROADSTONE GAEKE, MD, LLC

Practice address

82 N Breiel Blvd
Middletown, OH 45042-3804

Phone

(513) 422-3119

Fax

(513) 420-1848

NPI assigned

Apr 2, 2006

Organization subpart

No

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

Authorized official

Name

Mary Ellen Gaeke, MDNPI 1134180664

Title

Owner

Phone

(513) 422-3119

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Ellen Gaeke, MD

  • Hematology & Oncology Physician
  • Middletown, OH
  • NPI 1134180664
  NPD (past) Authorized official

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

{
    "created_epoch": "1143936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952362485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 N BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423804",
            "telephone_number": "513-422-3119",
            "fax_number": "513-420-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 N BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423804",
            "telephone_number": "513-422-3119",
            "fax_number": "513-420-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ELLEN BROADSTONE GAEKE, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAEKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-422-3119",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jadelyn Faith Marlen, RN
• Destany Alexus Marshall
• Alicea Martin Pressley, MSW LISW-S
• Elizabeth D Martin
• Leanne Martin, LMT CCT
• Gail Ann Mason, LPN
• Tammy L Mason, LPN
• Leeba Matthew, DNP
• Lora Matthews
• Kristen Mauk, CCC-SLP

• Hematology & Oncology Physician in Middletown, OH
• Providers in Middletown, OH by specialty
• Hematology & Oncology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.