Individual provider Active NPI

Brian Alex Kuvshinikov, DPM

  • Podiatrist
  • Dayton, OH
National Provider Identifier
1962407908
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36-003316 Issued in OH
Practice address
15 Southmoor Cir NE
Dayton, OH 45429-2451
Phone
(937) 293-6896
Fax
(937) 293-9150
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36-003316 OH Primary

Addresses

Primary practice location

15 Southmoor Cir NE
Dayton, OH 45429-2451

Mailing address

15 Southmoor Cir NE
Dayton, OH 45429-2451
Phone (937) 293-6896

Other identifiers 1

IdentifierTypeStateIssuer
2385066MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040317000128 OH Practitioner - Podiatry 2567352305 Reassigns benefits to 1 organization
I20250106002214 IN Practitioner - Podiatry 2567352305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Medical IncGroup PAC ID 5890765481, 80 clinicians
Onhealthcare LLCGroup PAC ID 8527221480, 29 clinicians

Practice addresses (Care Compare)

740 Commerce Dr
Suite a
Perrysburg, OH 43551-5276
Phone 24852821166

8425 Woodfield Crossing Blvd
Suite 100
Indianapolis, IN 46240-7316
Phone (248) 528-2116

Merit-based Incentive Payment System (MIPS)

Final score
93.57 of 100Reported as group
Quality
58.53
Promoting interoperability
100
Improvement activities
40
Cost
86.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue3003
Removal or shaving of skin growth97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36-003316OHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Onhealthcare LLC Podiatrist CurrentSince Dec 30, 2024 Accepting new patients
Onhealthcare, LLC Current Accepting new patients
Onhealthcare LLC CurrentSince Dec 30, 2024 Accepting new patients
Mobile Medical, Inc. CurrentSince Jan 23, 2024 Accepting new patients
Mobile Medical Inc Current Accepting new patients
Dixie a. Dooley, DPM, Inc. Past Accepting new patients
Mobile Medical, Inc. Podiatrist Past Accepting new patients

Locations

8425 Woodfield Crossing Blvd
Ste 100
Indianapolis, IN 46240
Phone (317) 537-9522

3255 Levis Commons Blvd
Perrysburg, OH 43551
Phone (419) 874-0393

740 Commerce Dr
Ste A
Perrysburg, OH 43551
Phone 24852821166

Organizations & group practices 7

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1962407908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SOUTHMOOR CIR NE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292451",
            "telephone_number": "937-293-6896",
            "fax_number": "937-293-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SOUTHMOOR CIR NE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292451",
            "telephone_number": "937-293-6896",
            "fax_number": "937-293-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUVSHINIKOV",
        "first_name": "BRIAN",
        "middle_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36-003316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2385066",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.